Mantinan Beatriz, Rego-Iraeta Antonia, Larrañaga Alejandra, Fluiters Enrique, Sánchez-Sobrino Paula, Garcia-Mayor Ricardo V
Endocrine, Diabetes, Nutrition and Metabolism Department, University Hospital of Vigo, P.O. Box 1691, Plaza de Compostela 3, 36201 Vigo, Spain.
J Thyroid Res. 2012;2012:469397. doi: 10.1155/2012/469397. Epub 2012 Oct 2.
Objective. To analyze some factors that could influence the outcome of patients with PTMC. Material and Methods. This is a longitudinal observational study. All patients diagnosed and treated for papillary thyroid microcarcinoma at the University Hospital of Vigo, between January 1994 and December 2003, were included in the present study. Demographic characteristics, tumour characteristics, TNM stage, rate of recurrence, and treatment with (131)I were the study variables. Results. Ninety-one patients (75 females) with an average age of 47.7 ± 13.4 years, range 19-81, were studied. Initial tumour staging was T1 in 90 patients and T4a in 1 case. Initial lymph node involvement was present in 4 cases (4.4%). We only found one case with distant metastases at diagnosis. Postsurgical evaluation of thyroid specimens revealed that 28 (30.7%) tumours were multifocal. The average size of the tumour was 0.44 ± 0.25 cm, range 0.1-1. Univariate analysis reveals a statistically significant association between tumour multifocality and postsurgical (131)I therapy with the recurrence rate. In the multivariate analysis only multifocality (P = 0.037, HR 5.7) was a significant risk factor for the recurrence rate. Conclusions. Our results indicate that tumour multifocality is an independent predictor of relapse but neither the tumour size nor postsurgical (131)I therapy.
目的。分析一些可能影响甲状腺微小乳头状癌(PTMC)患者预后的因素。材料与方法。这是一项纵向观察性研究。纳入了1994年1月至2003年12月期间在维戈大学医院诊断并接受治疗的所有甲状腺微小乳头状癌患者。人口统计学特征、肿瘤特征、TNM分期、复发率以及¹³¹I治疗情况为研究变量。结果。共研究了91例患者(75例女性),平均年龄为47.7±13.4岁,年龄范围19 - 81岁。初始肿瘤分期为T1期的患者有90例,T4a期1例。初始有4例(4.4%)出现淋巴结受累。诊断时仅发现1例有远处转移。对甲状腺标本的术后评估显示,28例(30.7%)肿瘤为多灶性。肿瘤平均大小为0.44±0.25 cm,范围0.1 - 1 cm。单因素分析显示肿瘤多灶性及术后¹³¹I治疗与复发率之间存在统计学显著关联。多因素分析中,只有多灶性(P = 0.037,HR 5.7)是复发率的显著危险因素。结论。我们的结果表明,肿瘤多灶性是复发的独立预测因素,而肿瘤大小及术后¹³¹I治疗并非如此。
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