Besic Nikola, Zgajnar Janez, Hocevar Marko, Frkovic-Grazio Snjezana
Department of Surgical Oncology, Institute of Oncology, Zaloska 2, Ljubljana, Slovenia.
Thyroid. 2005 May;15(5):439-48. doi: 10.1089/thy.2005.15.439.
The knowledge of prognostic factors is essential for an optimal treatment of patients. The aim of our study was to find out if age is an independent prognostic factor for patients with follicular or Hürthle cell carcinoma. This retrospective study was carried out in 261 patients (median age, 62 years) with follicular or Hürthle cell thyroid carcinoma treated at our institute from 1972-2002. For all patients the follow-up was performed at our institute at least once per year. The data on gender and age of the patients, disease history, extent of disease, morphologic characteristics, mode of therapy, outcome, and survival were collected. Statistical correlation between possible prognostic factors and cause-specific survival was analyzed by univariate and Cox's multivariate survival analysis. The 10-year and 20-year survival of all 261 patients were 70% and 42%, respectively. Even 10 of 49 (20%) of our patients who were under 45 years of age (i.e., in stage II of the tumor, node, metastases [TNM] classification system) died of disease. Multivariate analysis showed that primary tumor size and distant metastases were independent prognostic factors for survival. Lymph node metastases as well as the age of patients were not found to be independent prognostic factors. Therefore, the patients with distant metastases or tumor stage T4 who are under 45 years of age cannot be considered to have favorable prognosis.
了解预后因素对于患者的最佳治疗至关重要。我们研究的目的是确定年龄是否为滤泡性或许特莱细胞癌患者的独立预后因素。这项回顾性研究纳入了1972年至2002年在我们研究所接受治疗的261例（中位年龄62岁）滤泡性或许特莱细胞甲状腺癌患者。所有患者均在我们研究所每年至少进行一次随访。收集了患者的性别、年龄、病史、疾病范围、形态学特征、治疗方式、结局和生存数据。通过单因素和Cox多因素生存分析，分析了可能的预后因素与病因特异性生存之间的统计相关性。261例患者的10年和20年生存率分别为70%和42%。在我们45岁以下的49例患者中（即处于肿瘤、淋巴结、转移[TNM]分期系统的II期），甚至有10例（20%）死于该疾病。多因素分析表明，原发肿瘤大小和远处转移是生存的独立预后因素。未发现淋巴结转移以及患者年龄是独立预后因素。因此，45岁以下有远处转移或肿瘤分期为T4的患者不能被认为预后良好。
