Zidan J, Kassem S, Kuten A
Oncology Unit, Rebecca Sieff Government Hospital, Safed, Israel.
Am J Clin Oncol. 2000 Feb;23(1):1-5. doi: 10.1097/00000421-200002000-00001.
Prognostic variables and treatment outcomes of 82 patients treated at the Northern Israel Oncology Center were reviewed. There were 59 women and 23 men in this series. The female/male ratio was 2.6/1. Median age was 46 years. Median follow-up was 11.4 (range: 3.8-24 years). Median tumor size was 3.6 cm. When first seen, 4 patients had lymph node involvement and 11 (13%) had distant metastases. Surgical treatment was total thyroidectomy in 37 patients (45%), subtotal thyroidectomy in 38 (46%), and lesser procedures in 7 (9%). Sixty-six patients (80%) were treated after surgery with 131I to ablate thyroid remnants. Doses ranged between 30 and 80 mCi. The 20-year overall actuarial survival rate was 65%. The actuarial survival rate of patients <40 years of age was 96% versus 33% in patients >50 years of age (p = 0.0008). Patients with distant metastases at presentation had inferior survival compared with patients without metastases. In conclusion, we found subtotal thyroidectomy followed by 131I and hormone therapy to provide survival similar to that with total thyroidectomy, with less morbidity. Risk factors include: age > or =40 at the time of diagnosis, presence of distant metastases, capsular invasion, tumor size > or =2 cm, and male gender.
对在以色列北部肿瘤中心接受治疗的82例患者的预后变量和治疗结果进行了回顾。该系列中有59名女性和23名男性。男女比例为2.6/1。中位年龄为46岁。中位随访时间为11.4年（范围：3.8 - 24年）。中位肿瘤大小为3.6厘米。初诊时，4例患者有淋巴结受累，11例（13%）有远处转移。手术治疗中，37例患者（45%）行全甲状腺切除术，38例（46%）行次全甲状腺切除术，7例（9%）行较小手术。66例患者（80%）术后接受131I治疗以消融甲状腺残余组织。剂量范围在30至80毫居里之间。20年总精算生存率为65%。年龄<40岁患者的精算生存率为96%，而年龄>50岁患者为33%（p = 0.0008）。初诊时有远处转移的患者生存率低于无转移患者。总之，我们发现次全甲状腺切除术后联合131I和激素治疗的生存率与全甲状腺切除术相似，但发病率较低。危险因素包括：诊断时年龄≥40岁、存在远处转移、包膜侵犯、肿瘤大小≥2厘米以及男性性别。
