Tan LC, Huang NS, Yu PC, et al. - Different clinicopathologic factors predispose to different patterns of metastases, resulting in significant short-term survival differences among patients with differentiated thyroid cancer (DTC). The findings may aid in the development of effective pretreatment screening for aggressive metastatic patterns at the time of initial diagnosis, allowing for additional treatment or access to clinical trials for these patients.

• The Surveillance, Epidemiology, and End Results database was used to identify 530 people with distant DTC diagnosed between 2010 and 2014.

• Patients with distant lymph node (LN)-only, bone-only, lung-only, bone plus lung, and liver and/or brain metastases (Mets) were 50, 111, 263, 59, and 47, respectively.

• The only confirmed risk factors for distant LN-only Mets and bone-only Mets were regional lymph node metastasis and follicular histotype, respectively.

• Lung-only Mets were associated with larger tumor size, extrathyroidal extension, and a papillary histotype.

• Synchronous bone and lung Mets were more common in older patients.

• Furthermore, patients with distant LN-only Mets had little effect on overall and thyroid cancer-specific survival, whereas those with synchronous bone and lung or liver/brain Mets had poor short-term outcomes regardless of whether they received total thyroidectomy and radioisotopes.