Department of Surgery, Kuma Hospital, Kobe 650-0011, Japan.
Endocr J. 2012;59(5):399-405. doi: 10.1507/endocrj.ej12-0044. Epub 2012 Feb 29.
Age is an important prognostic factor in papillary thyroid carcinoma (PTC). In this study, we investigated the difference in prognosis of 7 subsets of PTC patients without distant metastasis at presentation or a history of radiation exposure (20 years or younger, 21-30 years, 31-40 years, 41-50 years, 51-60 years, 61-70 years, and older than 70 years). The lymph node recurrence rate was high in patients 20 years or younger and those older than 60 years. Distant recurrence and carcinoma death rates significantly elevated in patients older than 60 years. The incidence of significant extrathyroid extension markedly increased with age, although that of large node metastasis or extranodal tumor extension did not differ much among the 7 subsets. With the Kaplan-Meier method, lymph node recurrence rate was poor in patients 20 years or younger and in those older than 60 years. Poor distant recurrence-free and cause specific survivals of patients older than 60 years were identified in the series of PTC patients with and without these aggressive features. It is therefore suggested that 1) Lymph node recurrence rate was high in patients 20 years or younger and those older than 60 years and 2) prognosis, including distant recurrence-free survival and cause-specific survival, of patients older than 60 years was poor regardless of clinicopathological features of PTC at initial surgery.
年龄是甲状腺乳头状癌(PTC)的一个重要预后因素。在这项研究中,我们研究了 7 组无远处转移或无辐射暴露史(20 岁以下、21-30 岁、31-40 岁、41-50 岁、51-60 岁、61-70 岁和 70 岁以上)的 PTC 患者的预后差异。20 岁以下和 60 岁以上的患者淋巴结复发率较高。60 岁以上的患者远处复发和癌症死亡率显著升高。虽然 7 组之间的大淋巴结转移或肿瘤外侵的发生率没有太大差异,但明显的甲状腺外侵犯发生率随着年龄的增长而增加。采用 Kaplan-Meier 法,20 岁以下和 60 岁以上患者的淋巴结复发率较差。在有无这些侵袭性特征的 PTC 患者系列中,60 岁以上患者的远处无复发生存率和原因特异性生存率较差。因此,建议 1)20 岁以下和 60 岁以上患者的淋巴结复发率较高,2)无论初始手术时 PTC 的临床病理特征如何,60 岁以上患者的预后,包括远处无复发生存率和原因特异性生存率均较差。