JCEM:叶切除术会增加甲状腺乳头状癌复发风险?

2016-10-23 MedSci MedSci原创

研究数据显示,对于小乳头状甲状腺癌成年患者,接受叶切除术或肿瘤直径至少1.8 cm,两个或两个以上转移性淋巴结或双侧肿瘤,患者的长期复发风险增加。 韩国国立首尔大学医学院的Ka Hee Yi博士和同事进行了一项全国性的、回顾性、多中心研究,包括3282名(平均年龄47岁)甲状腺乳头状癌成年患者,肿瘤直径不超过2 cm。 平均随访5.8年。评估与长期复发相关的高危因素。 总的来说,

研究数据显示,对于小乳头状甲状腺癌成年患者,接受叶切除术者或肿瘤直径至少1.8 cm,两个或两个以上转移性淋巴结或双侧肿瘤,患者的长期复发风险增加。

韩国国立首尔大学医学院的Ka Hee Yi博士和同事进行了一项全国性的、回顾性、多中心研究,包括3282名(平均年龄47岁)甲状腺乳头状癌成年患者,肿瘤直径不超过2 cm。

平均随访5.8年。评估与长期复发相关的高危因素。

总的来说,86%的患者进行了近全或次全甲状腺切除术,77.4%的患者进行了放射性碘消融治疗。

基于肿瘤大小从0.7 cm到1.9 cm,将患者分为两组。为预测复发的风险,肿瘤直径最佳值为1.8 cm。

随访过程中190例患者复发。5年复发率为4.5%,10年复发率为8.9%。

叶切除术组患者与全甲状腺切除术组患者相比,5年和10年的复发率均更高。

最常见的复发部位是颈部淋巴结(64%),其次是甲状腺床和肺。

与长期复发风险相关的因素还有:年龄超过45岁(HR = 0.74; 95% CI, 0.55-0.98),肿瘤直径至少1.8 cm(HR = 2.39; 95% CI, 1.75-3.33),淋巴结转移和接受叶切除术(HR = 1.71; 95% CI, 1.19-2.45)。

原始出处:

Lobectomy may increase recurrence in small papillary thyroid cancer.Healio.October 18, 2016

Hwangbo Y, et al. Long-term Recurrence of Small Papillary Thyroid Cancer and Its Risk Factors in a Korean Multicenter Study.J Clin Endocrinol Metab. 2016;doi:10.1210/jc.2016-2287.

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    2017-08-11 smallant2015
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    2017-04-23 achengzhao
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