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甲状腺残余叶中乳头状甲状腺癌的临床复发

Clinical recurrence of papillary thyroid cancer in the remnant lobe.

作者信息

Asanuma K, Kobayashi S, Sugenoya A, Yokoyama S, Shingu K, Hama Y, Itoh N, Kasuga Y, Amano J

机构信息

Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.

出版信息

Eur J Surg. 2000 Mar;166(3):202-6. doi: 10.1080/110241500750009276.

Abstract

OBJECTIVE

To find out which factors predict recurrence of cancer in the remnant after unilateral thyroid lobectomy for patients with papillary cancer.

DESIGN

Retrospective study.

SETTING

Teaching hospital, Japan.

SUBJECTS

One hundred thirty-three patients with a clinically solitary papillary thyroid cancer who had unilateral lobectomy for the primary disease between 1966 and 1990 and were followed up for more than 60 months. Twelve patients had developed recurrences in the remnant gland by the time of the second operation and 121 patients had not as judged by a second operation, an ultrasound examination, or by palpation.

RESULT

The primary tumour size in those who developed recurrences was significantly larger than in those who did not (p < 0.0001), and clinical signs of regional lymph node involvement or distant metastases were also significantly more common (p = 0.006). No patient died of their cancer.

CONCLUSION

Size of the primary tumour is an important prognostic factor for recurrence of solitary papillary thyroid cancer in the remnant after unilateral lobectomy. Such recurrences are unlikely to be lethal.

摘要

目的

明确哪些因素可预测甲状腺乳头状癌患者单侧甲状腺叶切除术后残叶中癌症的复发情况。

设计

回顾性研究。

地点

日本教学医院。

研究对象

1966年至1990年间因原发性疾病接受单侧叶切除术且随访时间超过60个月的133例临床孤立性甲状腺乳头状癌患者。通过二次手术、超声检查或触诊判断,其中12例患者在二次手术时残叶出现复发,121例患者未复发。

结果

复发患者的原发肿瘤大小显著大于未复发患者(p < 0.0001),区域淋巴结受累或远处转移的临床体征在复发患者中也明显更常见(p = 0.006)。无患者死于癌症。

结论

原发肿瘤大小是单侧叶切除术后残叶中孤立性甲状腺乳头状癌复发的重要预后因素。此类复发不太可能致命。

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