Liver metastases in thyroid cancer: epidemiology, risk stratification and survival outcomes in the immunotherapy era

PurposeLiver metastases in thyroid cancer are rare but fatal, with poorly defined risk profiles and survival outcomes. This study aimed to characterize epidemiology, risk factors and outcomes of this disease using a population-based approach, further explore the potential impact of the immunotherapy...

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Main Authors: Ming-Lu Xu, Yang-Yang Wang, Li-Ping Xie, Ning Ding, Jia-Jun Hui
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1624181/full
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author Ming-Lu Xu
Yang-Yang Wang
Li-Ping Xie
Ning Ding
Jia-Jun Hui
author_facet Ming-Lu Xu
Yang-Yang Wang
Li-Ping Xie
Ning Ding
Jia-Jun Hui
author_sort Ming-Lu Xu
collection DOAJ
description PurposeLiver metastases in thyroid cancer are rare but fatal, with poorly defined risk profiles and survival outcomes. This study aimed to characterize epidemiology, risk factors and outcomes of this disease using a population-based approach, further explore the potential impact of the immunotherapy era on the prognosis of these patients.MethodsData on 116,801 thyroid cancer cases from SEER program (2010-2021) were analyzed. The clinicopathological features of patients with and without liver metastases were compared. Logistic regression analyses were employed to identify the predictors for liver metastases, while survival determinants were determined using Cox regression models. The predictive nomogram was developed for liver metastasis risk assessment, validated using concordance index, calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). In addition, we further compared the prognostic outcomes of these patients in the immunotherapy era.ResultsThe prevalence of liver metastasis in thyroid cancer was 0.22% (95%CI 0.20%-0.25%), predominantly in medullary thyroid carcinoma (MTC) and anaplastic thyroid carcinoma (ATC). MTC exhibited the highest risk of metastasis (OR=35.7, 95%CI 24.1–52.8). The nomogram for liver metastasis risk (C-index=0.98) demonstrated robust discriminatory ability and clinical utility. The median overall survival (OS) was 6.0 months (95%CI 4.0–8.0), with survival rates of 38.1% at 1 year, 28.3% at 3 years, and 16.5% at 5 years. Patients with ATC and rare histology types experienced significantly shorter survival. No statistically significant difference in mOS and median cancer-specific survival (mCSS) of these patients between the pre- and post-immunotherapy eras were observed (P>0.05 for both).ConclusionThis study establishes the first population-based predictive framework for liver metastases in thyroid cancer, underscoring risk stratification and survival. These findings also highlight the critical need to optimize survival outcomes for this aggressive metastatic phenotype in immunotherapy era.
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spelling doaj-art-36eac41ef87b49b9bfa0a2269879a7d62025-08-20T03:55:48ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.16241811624181Liver metastases in thyroid cancer: epidemiology, risk stratification and survival outcomes in the immunotherapy eraMing-Lu Xu0Yang-Yang Wang1Li-Ping Xie2Ning Ding3Jia-Jun Hui4Department of Medical Oncology, Wuxi Huishan District People’s Hospital, Affiliated Huishan Hospital of Xinglin College, Nantong University, Wuxi, ChinaDepartment of Otolaryngology, Wuxi Huishan District People’s Hospital, Affiliated Huishan Hospital of Xinglin College, Nantong University, Wuxi, ChinaDepartment of Medical Oncology, Suzhou Dushu Lake Hospital, The Fourth Affiliated Hospital of Soochow University, Suzhou, ChinaDepartment of Medical Oncology, Wuxi Huishan District People’s Hospital, Affiliated Huishan Hospital of Xinglin College, Nantong University, Wuxi, ChinaDepartment of Medical Oncology, Wuxi Huishan District People’s Hospital, Affiliated Huishan Hospital of Xinglin College, Nantong University, Wuxi, ChinaPurposeLiver metastases in thyroid cancer are rare but fatal, with poorly defined risk profiles and survival outcomes. This study aimed to characterize epidemiology, risk factors and outcomes of this disease using a population-based approach, further explore the potential impact of the immunotherapy era on the prognosis of these patients.MethodsData on 116,801 thyroid cancer cases from SEER program (2010-2021) were analyzed. The clinicopathological features of patients with and without liver metastases were compared. Logistic regression analyses were employed to identify the predictors for liver metastases, while survival determinants were determined using Cox regression models. The predictive nomogram was developed for liver metastasis risk assessment, validated using concordance index, calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). In addition, we further compared the prognostic outcomes of these patients in the immunotherapy era.ResultsThe prevalence of liver metastasis in thyroid cancer was 0.22% (95%CI 0.20%-0.25%), predominantly in medullary thyroid carcinoma (MTC) and anaplastic thyroid carcinoma (ATC). MTC exhibited the highest risk of metastasis (OR=35.7, 95%CI 24.1–52.8). The nomogram for liver metastasis risk (C-index=0.98) demonstrated robust discriminatory ability and clinical utility. The median overall survival (OS) was 6.0 months (95%CI 4.0–8.0), with survival rates of 38.1% at 1 year, 28.3% at 3 years, and 16.5% at 5 years. Patients with ATC and rare histology types experienced significantly shorter survival. No statistically significant difference in mOS and median cancer-specific survival (mCSS) of these patients between the pre- and post-immunotherapy eras were observed (P>0.05 for both).ConclusionThis study establishes the first population-based predictive framework for liver metastases in thyroid cancer, underscoring risk stratification and survival. These findings also highlight the critical need to optimize survival outcomes for this aggressive metastatic phenotype in immunotherapy era.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1624181/fullthyroid cancerliver metastasesSEER databasenomogramrisk predictionsurvival analysis
spellingShingle Ming-Lu Xu
Yang-Yang Wang
Li-Ping Xie
Ning Ding
Jia-Jun Hui
Liver metastases in thyroid cancer: epidemiology, risk stratification and survival outcomes in the immunotherapy era
Frontiers in Immunology
thyroid cancer
liver metastases
SEER database
nomogram
risk prediction
survival analysis
title Liver metastases in thyroid cancer: epidemiology, risk stratification and survival outcomes in the immunotherapy era
title_full Liver metastases in thyroid cancer: epidemiology, risk stratification and survival outcomes in the immunotherapy era
title_fullStr Liver metastases in thyroid cancer: epidemiology, risk stratification and survival outcomes in the immunotherapy era
title_full_unstemmed Liver metastases in thyroid cancer: epidemiology, risk stratification and survival outcomes in the immunotherapy era
title_short Liver metastases in thyroid cancer: epidemiology, risk stratification and survival outcomes in the immunotherapy era
title_sort liver metastases in thyroid cancer epidemiology risk stratification and survival outcomes in the immunotherapy era
topic thyroid cancer
liver metastases
SEER database
nomogram
risk prediction
survival analysis
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1624181/full
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AT lipingxie livermetastasesinthyroidcancerepidemiologyriskstratificationandsurvivaloutcomesintheimmunotherapyera
AT ningding livermetastasesinthyroidcancerepidemiologyriskstratificationandsurvivaloutcomesintheimmunotherapyera
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