World Journal of Surgery

, Volume 42, Issue 11, pp 3632–3637 | Cite as

Clinical Status and Treatment of Liver Metastasis of Differentiated Thyroid Cancer Using Tyrosine Kinase Inhibitors

  • Yoshiyuki Saito
  • Kiminori SuginoEmail author
  • Hiroshi Takami
  • Kenichi Matsuzu
  • Takashi Uruno
  • Keiko Ohkuwa
  • Wataru Kitagawa
  • Mitsuji Nagahama
  • Hirofumi Kawakubo
  • Koichi Ito
  • Yuko Kitagawa
Original Scientific Report



Treatment of patients with liver metastasis of differentiated thyroid carcinoma (DTC) has not been sufficiently defined, because liver metastasis of DTC has been described mostly as case reports. Additionally, such patients are considered end-of-treatment responders. A relatively new approach using tyrosine kinase inhibitors (TKIs) may provide opportunities to manage systemic metastasis. This study aims to define the clinical features of DTC patients with liver metastasis and evaluate the benefits of TKIs.


We retrospectively analyzed clinical features of 29 patients (mean age 67.8 years) diagnosed with liver metastasis of DTC at our institution between January 1981 and May 2017.


All patients had distant metastasis at other organ sites upon diagnosis of liver metastasis; 41% of them developed new metastasis afterward. Management after diagnosis of liver metastasis comprised palliative care (48%), radioactive iodine therapy (28%), and TKI therapy (24%). The median survival after diagnosis of liver metastasis was only 4.8 months. Survival rates were significantly better in patients with performance statuses between 0 and 2 on the Eastern Cooperative Oncology Group scale at diagnosis of liver metastasis (n = 22, 76%) treated with TKI compared to those who were not (P = 0.017; log-rank test; hazard ratio 0.19). One-year survival rates were 71.4 and 26.7% for patients treated with or without TKI, respectively.


Patients with liver metastasis had poor clinical prognosis. When other distant metastases existed at diagnosis of liver metastasis, TKI therapy was considered an effective therapeutic option for patients with liver metastasis of DTC.


Authors’ contribution

YS, KS, HT, TU, and KO contributed to study conception and design. YS, KS, and KM helped in analysis and interpretation of data. YS, KS, and HT contributed to drafting manuscript. WK, MN, HK, KI, and YK helped in revising the manuscript. YK contributed to final approval of the article.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest to disclose.


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Yoshiyuki Saito
    • 1
    • 2
  • Kiminori Sugino
    • 1
    Email author
  • Hiroshi Takami
    • 1
  • Kenichi Matsuzu
    • 1
  • Takashi Uruno
    • 1
  • Keiko Ohkuwa
    • 1
  • Wataru Kitagawa
    • 1
  • Mitsuji Nagahama
    • 1
  • Hirofumi Kawakubo
    • 2
  • Koichi Ito
    • 1
  • Yuko Kitagawa
    • 2
  1. 1.Department of SurgeryIto HospitalTokyoJapan
  2. 2.Department of Surgery, School of MedicineKeio UniversityTokyoJapan

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