Department of Surgery, School of Medicine, Universidad de La Sabana, Chia, Colombia.
Clin Transl Oncol. 2011 Sep;13(9):692-6. doi: 10.1007/s12094-011-0716-8.
The treatment for thyroid cancer is surgical. However, some patients do not undergo operations because of comorbidities or other reasons. There is little information about the prognosis of these patients. The aim of the present study was to describe patients with well differentiated thyroid carcinoma who did not undergo surgical treatment and to identify differences in prognostic variables and survival compared with patients treated surgically.
We conducted a retrospective review of a prospective cohort collected by the National Cancer Institute obtained from the Surveillance, Epidemiology and End Results (SEER) Program. All patient files with a diagnosis of thyroid cancer were selected (38,493 cases). Finally, 12,416 cases were used for the analysis. Treatment was divided into surgical or nonsurgical groups. Five-year survival rates were estimated and classified by the SEER stage.
Eighty-six patients did not receive surgical treatment. These patients were older, had more advanced tumours and their treatment was less associated with complementary radiotherapy. Five-year overall survival rates were 96.7% for surgical patients vs. 56.8% for nonsurgical patients (p<0.001). The overall survival in the nonsurgery group for localised tumours decreased 14.9%, for regional tumours decreased 49.9% and for distant tumours decreased 61.8%.
The patients who did not undergo surgical treatment showed less than 5-year overall survival. The SEER database does not offer information about comorbidities that could explain these differences.
甲状腺癌的治疗方法是手术。然而，由于合并症或其他原因，有些患者无法进行手术。关于这些患者的预后信息很少。本研究的目的是描述未接受手术治疗的分化型甲状腺癌患者，并与接受手术治疗的患者比较预后变量和生存差异。
我们对国家癌症研究所通过监测、流行病学和最终结果（SEER）计划收集的前瞻性队列进行了回顾性研究。选择所有诊断为甲状腺癌的患者档案（38493 例）。最终，有 12416 例病例用于分析。治疗分为手术和非手术组。通过 SEER 分期估计并分类 5 年生存率。
86 例患者未接受手术治疗。这些患者年龄较大，肿瘤进展程度较高，且其治疗与补充放疗的相关性较低。手术组 5 年总生存率为 96.7%，而非手术组为 56.8%（p<0.001）。局部肿瘤、区域肿瘤和远处肿瘤的非手术组 5 年总生存率分别下降了 14.9%、49.9%和 61.8%。
未接受手术治疗的患者总生存率不到 5 年。SEER 数据库未提供可解释这些差异的合并症信息。
