Mihailovic Jasna, Stefanovic Ljubomir, Malesevic Milica
Department of Nuclear Medicine, Institute of Oncology Sremska Kamenica, Sremska Kamenica, Serbia.
Cancer Biother Radiopharm. 2007 Apr;22(2):250-5. doi: 10.1089/cbr.2006.313.
The purpose was to analyze survival and its predicting factors in differentiated thyroid carcinoma (DTC) patients with distant metastases (M1). Radioiodine ((131)I) therapy was performed in 363 DTC patients from 1977 to 2000. Among 75 patients, 44 patients had M1 at the time of initial therapy and 31 patients had M1, which developed during the follow up. The probability of survival and its predicting factors were tested by Kaplan-Meier's method. Seventy five DTC patients with M1 included 49 (65.3%) women and 26 (34.7%) men; 30 (40%) patients were < 45 years old and 45 (60%) patients were >or= 45 years old (range 8-70 years; mean age = 45.5 years); 52 papillary carcinomas, 22 follicular carcinomas, and one inconclusive finding. Probability of survival after appearance of M1 was 60.7% at 5 years, 51.2% at 10, and 38.4% at 15 and 20 years. Some predicting factors showed significant influence on the survival: age (p = 0.0001), histological type (p = 0.0138), and initial therapy (p = 0.0351), while gender had no influence (p = 0.2046). We can conclude that patients' age, histopathology of the tumor, and initial therapy significantly influence the survival. Longer survival of DTC patients with M1 could be achieved by adequate surgery followed by 131I therapy.
目的是分析分化型甲状腺癌（DTC）伴远处转移（M1）患者的生存率及其预测因素。1977年至2000年对363例DTC患者进行了放射性碘（（131）I）治疗。在75例患者中，44例在初始治疗时即有M1，31例在随访期间出现M1。采用Kaplan-Meier法检测生存率及其预测因素。75例M1期DTC患者中，女性49例（65.3%），男性26例（34.7%）；30例（40%）患者年龄<45岁，45例（60%）患者年龄≥45岁（范围8 - 70岁；平均年龄 = 45.5岁）；52例乳头状癌，22例滤泡状癌，1例结果不明确。出现M1后5年生存率为60.7%，10年为51.2%，15年和20年为38.4%。一些预测因素对生存率有显著影响：年龄（p = 0.0001）、组织学类型（p = 0.0138）和初始治疗（p = 0.0351），而性别无影响（p = 0.2046）。我们可以得出结论，患者年龄、肿瘤组织病理学和初始治疗对生存率有显著影响。通过充分手术继以131I治疗可使M1期DTC患者获得更长生存期。
