Kus Lukas H, Shah Manish, Eski Spiro, Walfish Paul G, Freeman Jeremy L
Queen's University, Kingston, Canada.
Arch Otolaryngol Head Neck Surg. 2010 Feb;136(2):138-42. doi: 10.1001/archoto.2009.206.
To compare the outcomes of patients having thyroid cancer among Filipinos vs non-Filipinos.
Retrospective medical record review.
High-volume tertiary referral center in Toronto, Ontario, Canada.
A total of 499 patients with thyroid cancer (36 Filipino and 463 non-Filipino) treated at Mount Sinai Hospital from January 1, 1984, to August 31, 2003, with a minimum 5-year follow-up period and a minimum 1.0-cm tumor size. Patients were identified from a thyroid cancer database. Data on patient, tumor, and treatment factors were collected along with outcomes.
The presence of thyroid cancer recurrence, the rate of death from disease, and the time to recurrence.
The 2 groups were similar for sex, age, history of head and neck radiation exposure, family history of thyroid cancer, follow-up time, tumor size, tumor pathologic findings, presence of tumor multifocality, stage of primary disease, type of thyroid surgery, use of postoperative radioactive iodine therapy, and use of external beam radiation therapy. Filipino patients experienced a thyroid cancer recurrence rate of 25% compared with 9.5% for non-Filipino patients (odds ratio, 3.20; 95% confidence interval, 1.23-7.49; P = .004). On multivariate analysis, the increased risk of thyroid cancer recurrence persisted for Filipino patients (odds ratio, 6.99; 95% confidence interval, 2.31-21.07; P < .001). No significant differences were noted between Filipino patients and non-Filipino patients regarding the rate of death from disease (5.6% vs 1.9%) and the time to recurrence (52.6 vs 53.1 months).
Filipino patients have a significantly higher risk of thyroid cancer recurrence compared with non-Filipino patients. However, no significant difference was noted in the time to recurrence or the rate of death from disease. These findings justify a more aggressive initial management and follow-up regimen for Filipino patients with thyroid cancer.
比较菲律宾裔与非菲律宾裔甲状腺癌患者的治疗结果。
回顾性病历审查。
加拿大安大略省多伦多的一家大型三级转诊中心。
1984年1月1日至2003年8月31日在西奈山医院接受治疗的499例甲状腺癌患者（36例菲律宾裔和463例非菲律宾裔），随访期至少5年，肿瘤大小至少1.0厘米。患者从甲状腺癌数据库中识别。收集患者、肿瘤和治疗因素的数据以及治疗结果。
甲状腺癌复发情况、疾病死亡率和复发时间。
两组在性别、年龄、头颈部辐射暴露史、甲状腺癌家族史、随访时间、肿瘤大小、肿瘤病理结果、肿瘤多灶性、原发疾病分期、甲状腺手术类型、术后放射性碘治疗的使用以及外照射放疗的使用方面相似。菲律宾裔患者的甲状腺癌复发率为25%，而非菲律宾裔患者为9.5%（优势比，3.20；95%置信区间，1.23 - 7.49；P = .004）。多因素分析显示，菲律宾裔患者甲状腺癌复发风险仍较高（优势比，6.99；95%置信区间，2.31 - 21.07；P < .001）。在疾病死亡率（5.6%对1.9%）和复发时间（52.6对53.1个月）方面，菲律宾裔患者与非菲律宾裔患者之间未观察到显著差异。
与非菲律宾裔患者相比，菲律宾裔患者甲状腺癌复发风险显著更高。然而，在复发时间或疾病死亡率方面未观察到显著差异。这些发现证明对菲律宾裔甲状腺癌患者应采取更积极的初始治疗和随访方案。
