The bone and liver are the most common sites of distant metastases for patients with medullary thyroid carcinoma (MTC), according to the results of a new study published in Head & Neck.

The authors observed the distant metastatic patterns of thyroid cancer subtypes as well as their corresponding survival rates. The most common site of metastasis for MTC, as well as follicular thyroid carcinoma (FTC), was the bone.

The lungs were the primary site for anaplastic thyroid carcinoma (ATC), poorly differentiated thyroid carcinoma (PDTC), papillary thyroid carcinoma (PTC), and Hurthle cell carcinoma (HCC).

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The median overall survival (OS) rates of patients with metastatic MTC were found to be 12.0 months which was an intermediate-length of time compared to the other cancer subtypes. Patients with ATC had the worst survival rates with a median OS of 2 months.

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After the bone site, the second most common site for MTC was the liver (42.7%), which occurred in a significantly higher proportion of patients than the other thyroid cancer subtypes (P <.001). Metastases to the lungs were also fairly common for MTC, and 40.6% of patients presented with metastases to multiple organs at the time of diagnosis.

As a whole, patients with thyroid cancer that had metastasized to multiple organs had a much worse outcome compared to those who only had metastases to a single organ (hazard ratio=1.810; 95% CI, 1.624–2.017; P <.001).

“Given the relatively frequent occurrence of multi-organ metastases in thyroid cancers with [distant metastasis] at presentation and its adverse impact on patient outcome, clinicians should consider searching for additional metastases according to each specific histology and confounding risk factors,” the authors said.

“In conclusion, this study demonstrated that different thyroid cancer subtypes remotely spread to specific organs and have unique metastatic patterns, which are important for patient counseling and mortality risk stratification.”

The patient data for a total of 2787 patients with metastatic thyroid cancer was collected from the Surveillance, Epidemiology, End Results registries and was included in the study. MTC cases totaled 208 of the cases.


Vuong HG, Le MK, Hassell L, Kondo T, Kakudo K. The differences in distant metastatic patterns and their corresponding survival between thyroid cancer subtypes. Head Neck. Published online January 25, 2022. doi:10.1002/hed.26987