ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1624181
This article is part of the Research TopicCancer Metastases: Mechanisms of Tumor Dissemination, Formation of Metastatic Niche and Anti-metastatic TherapyView all 14 articles
Liver metastases in thyroid cancer: epidemiology, risk stratification and survival Outcomes in the immunotherapy era
Provisionally accepted
- Wuxi Huishan District People's Hospital, Wuxi, China
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Abstract:Purpose: Liver 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. Methods: Data 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. Results: The 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). Conclusion: This 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.
Keywords: thyroid cancer, liver metastases, SEER database, nomogram, risk prediction, survival analysis, Immunotherapy
Received: 07 May 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Xu, Wang, Xie, Ding and Hui. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jia-Jun Hui, Wuxi Huishan District People's Hospital, Wuxi, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.