Al-Qahtani Khalid H, Al-Asiri Mushabbab, Tunio Mutahir A, Aljohani Naji J, Bayoumi Yasser, Al-Hussain Hussain, Maklad Ahmad M
Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
Saudi Med J. 2015 Apr;36(4):442-8. doi: 10.15537/smj.2015.4.10341.
To evaluate the clinicopathologic features, and explore the treatment outcomes of synchronous, or metachronous second primary malignancies (SPM) in conjunction with differentiated thyroid cancers (DTC).
This retrospective study was conducted on 823 DTC patients treated between 2000 and 2012 at 2 tertiary care hospitals (King Fahad Medical City and King Khalid University Hospital) in Riyadh, Kingdom of Saudi Arabia. Forty-one (5%) DTC patients were found to have SPM (61% metachronous and 39% synchronous). These patients with SPM were studied for clinicopathological features and treatment outcomes.
The patients with DTC and SPM were older (median age: 54.3 years) than those without SPM (median age: 43.2 years); p=0.04. The frequency of SPM was breast (51.2%), colon (12.2%), kidney (7.3%), astrocytoma (7.3%), parotid (7.3%), rectum (4.9%), lymphoma (4.9%), nasopharynx (2.4%), and stomach (2.4%). Median follow-up was 8.05 years. Ten-year disease free survival, and overall survival (OS) rates were lower in DTC patients with SPM (56.1% for 10-year survival, and 71.7% for OS) than without SPM (95.5% for 10-year survival, and 97.8% for OS); p=0.0001. Metachronous SPM had better 10-year disease free survival rates (60.2%) than synchronous SPM (45%).
The co-occurrence of SPM with DTC affects long-term disease free survival and OS rates.
评估同步或异时性第二原发性恶性肿瘤（SPM）合并分化型甲状腺癌（DTC）的临床病理特征，并探讨其治疗效果。
本回顾性研究对2000年至2012年期间在沙特阿拉伯利雅得的两家三级医疗中心（法赫德国王医疗城和哈立德国王大学医院）接受治疗的823例DTC患者进行。发现41例（5%）DTC患者患有SPM（61%为异时性，39%为同步性）。对这些患有SPM的患者的临床病理特征和治疗效果进行研究。
患有DTC和SPM的患者（中位年龄：54.3岁）比未患SPM的患者（中位年龄：43.2岁）年龄更大；p = 0.04。SPM的发生部位依次为乳腺（51.2%）、结肠（12.2%）、肾脏（7.3%）、星形细胞瘤（7.3%）、腮腺（7.3%）、直肠（4.9%）、淋巴瘤（4.9%）、鼻咽（2.4%）和胃（2.4%）。中位随访时间为8.05年。患有SPM的DTC患者的10年无病生存率和总生存率（OS）（10年生存率为56.1%，OS为71.7%）低于未患SPM的患者（10年生存率为95.5%，OS为97.8%）；p = 0.0001。异时性SPM的10年无病生存率（60.2%）优于同步性SPM（45%）。
SPM与DTC的同时发生会影响长期无病生存率和OS率。
