@article{oai:nagasaki-u.repo.nii.ac.jp:00000570,
 author = {Nakashima, Yomi and Ando, Takao and Nozaki, Aya and Ito, Ayako and Horie, Ichiro and Imaizumi, Misa and Usa, Toshiro and Kawakami, Atsushi},
 issue = {2},
 journal = {Acta medica Nagasakiensia},
 month = {Mar},
 note = {Background: Lenvatinib is one of the few therapeutic options available for radioiodine-refractory thyroid cancer. However, the factors that determine the therapeutic outcomes remain unknown.
Methods: Patients with thyroid carcinoma treated with lenvatinib who had been dead or who had survived for longer than a halfyear
were retrospectively compared. We evaluated the clinical parameters when lenvatinib was started, and also studied the tumor volume reduction ratio, the duration until re-growth of the largest metastatic lesion, the thyroglobulin (Tg) reduction rate,and the duration until re-elevation of Tg after lenvatinib between survivors and dead patients.Results: We identified 16 patients, with an average age of 73.1±7.6 yrs and a male-to-female ratio of 5 to 11, who had advanced differentiated thyroid cancer that was treated with lenvatinib. Nine patients had died after 8.9±6.1 months, whereas 7 survived for 13.0±2.0 months after starting lenvatinib. The patients who died were older than the survivors (76.7±6.5 vs. 68.6±6.6 yrs, p=0.03).Malignant pleural effusion (p=0.017) and symptomatic metastatic disease (SMD) (p=0.039) were associated with death in a Kaplan-Meier survival analysis. Age (p=0.012, HR 1.150, CI 1.030-1.320) and SMD (p=0.014, HR 8.069, CI 1.503-61.34) were
associated with poor outcome in a multivariate Cox proportional hazard model. The duration until the re-elevation of Tg was
longer in survivors than in patients who died (6.43±4.55 vs. 2.17±1.39 months, p=0.025).Conclusions: We identified multiple factors, including SMD, that were related to poor outcomes after lenvatinib treatment. This study suggests that lenvatinib might be started before patients develop SMD., Acta medica Nagasakiensia, 63(2), pp.71-77; 2020},
 pages = {71--77},
 title = {Age, Symptomatic Metastatic Disease, and Malignant Pleural Effusion as Predictors of Poor Prognosis in Patients with Differentiated Thyroid Carcinoma Treated with Lenvatinib.},
 volume = {63},
 year = {2020}
}