Sperlongano Pasquale, Parmeggiani Domenico, Pisaniello Donatella, De Falco Massimo, Sordelli Ignazio, Accardo Marina, Cuccurullo Vincenzo, Mansi Luigi, Tartaro Gian Paolo, Barbarisi Alfonso, Avenia Nicola, Parmeggiani Umberto
Department of Anaesthesiological, Surgical and Emergency Sciences, Second University of Naples, Naples, Italy.
Front Biosci. 2006 Sep 1;11:2206-12. doi: 10.2741/1963.
A retrospective study was carried out to assessed reliability of the prognostic factors (histology, age, sex, and stage), and standard procedures for the surgical treatment of differentiated thyroid cancers (DTC). From the 144 DTC cases reviewed with follow-up ranging from 1 to 25 years (m = 6.33 years), total mortality for cancer was found to be 55% (8 patients), with a predictive positive value for recurrence of 95.4% and 91.8% at 12 and 24 months, respectively. Median survival was 8.8 years (range 1 to 25 years). The multivariate analysis showed that factors such as age > 45 years, histology of intermediate malignancy, size up to 1.5 cm, and presence of metastases, significantly worsened the prognosis, regardless of the intervention that was carried out. We suggest total thyroidectomy for the treatment of benign pathologies and confirmed or suspected cases of cancer. We reserve loboisthmectomy for the treatment of benign pathologies confined to one lobe or those with FNAB suggesting a follicular neoplasm.
开展了一项回顾性研究，以评估预后因素（组织学、年龄、性别和分期）的可靠性，以及分化型甲状腺癌（DTC）手术治疗的标准程序。在回顾的144例DTC病例中，随访时间为1至25年（平均6.33年），发现癌症总死亡率为55%（8例患者），12个月和24个月时复发的预测阳性值分别为95.4%和91.8%。中位生存期为8.8年（范围1至25年）。多变量分析表明，年龄>45岁、中度恶性组织学、大小达1.5 cm以及存在转移等因素，无论采取何种干预措施，均会显著恶化预后。我们建议对良性病变以及确诊或疑似癌症病例进行全甲状腺切除术。我们保留甲状腺叶切除术用于治疗局限于一叶的良性病变或细针穿刺活检提示为滤泡性肿瘤的病变。
