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Summary objective Surgery of bone metastases from differentiated thyroid carcinoma seems indicated in individual patients. This study was performed (1) to analyse retrospectively patients with bone metastases from differentiated thyroid carcinoma and (2) to evaluate the impact of surgery of bone metastases on survival. patients and design We analysed 41 consecutive patients with bone metastases from differentiated thyroid carcinoma who had undergone thyroid surgery at Vienna University Hospital since 1966. The median follow-up time was 12 years. There were 24 females and 17 males with a mean age of 60 ± 12 years. Primary tumour histology was follicular in 35 and papillary in six patients. Radioiodine treatment was performed in 32 with a mean administered activity of 27 ± 24 GBq 131 I. Metastases restricted to the skeleton were found in 22 whereas in 19 individuals additional extraskeletal distant metastases were seen. Twenty-seven patients had multiple bone metastases. In 21 individuals, up to five bone metastases were surgically removed with the intention of cure. results Univariate analysis identified total thyroidectomy (P = 0·003), lymph node surgery (P = 0·001), radioiodine therapy (P = 0·036), and the absence of extraskeletal distant metastases (P = 0·017) as significant predictors of survival. Multivariate analysis failed to identify significant prognostic factors. In the subgroup of patients with distant metastases limited to the bones, univariate analysis identified, in addition to thyroid and lymph node surgery, the surgical extirpation of the bone metastases as a significant prognostic factor associated with improved survival (P = 0·025). conclusions These findings indicate that in patients without additional extraskeletal distant metastases, the radical surgical extirpation of bone metastases from differentiated thyroid carcinoma might be associated with improved survival. [ABSTRACT FROM AUTHOR]

Introduction: Several variables of health-related human behaviour have been analysed with regard to a possible association with lunar phases. The aim of this study was to evaluate a possible relation between the lunar cycle and the number of requests for appointments at an outpatient clinic. This variable has not been studied hitherto., Methods: We analysed a total number of 11,413 requests for appointments at our thyroid outpatient clinic during one year. Access to this clinic is not restricted, and all patients with known or suspected thyroid disease living in the area of Vienna may ask for an appointment. During the study period, 8,852 patients requested a follow-up appointment, and 2561 patients asked for a new appointment. We analysed a possible cyclic pattern in these requests using a nonlinear regression model based on both groups of patients., Results: A cosinus curve with a period of 29.531 days (the mean length of a lunar cycle) was significantly associated with the number of requests for both follow-up appointments (p = 0.007) and new appointments (p = 0.001). Requests for follow-up appointments had their highest peaks three days after the full moon, whereas requests for new appointments were most frequent five days afterwards., Conclusion: Our findings suggest that lunar phases may affect patients' requests for appointments at a thyroid outpatient clinic. To the best of our knowledge, this is the first study reporting a possible association between health-related behaviour and lunar phases using requests for appointments as a relevant variable. There is a need for more research into the mechanism underpinning this behaviour.