Megwalu U C
Department of Otolaryngology - Head and Neck Surgery,Stanford University School of Medicine,California,USA.
J Laryngol Otol. 2017 Feb;131(2):173-176. doi: 10.1017/S0022215116009762. Epub 2016 Dec 23.
To compare the effectiveness of non-surgical versus surgical therapy in elderly patients with papillary thyroid microcarcinoma.
The study cohort included 2323 elderly patients (aged 65 years and over) diagnosed with papillary thyroid microcarcinoma between 1988 and 2009, identified in the Surveillance, Epidemiology, and End Results 18 database of the National Cancer Institute.
The five-year overall survival rate was 23 per cent for non-surgical patients compared with 91 per cent for surgical patients (p < 0.0001). Unadjusted analysis revealed significantly improved survival in surgical patients compared with non-surgical patients (hazard ratio = 0.06; p < 0.0001). Propensity score analysis also revealed significantly improved survival in surgical patients compared with non-surgical patients (hazard ratio = 0.11; p < 0.0001).
Thyroidectomy appears to provide a survival benefit for elderly patients with papillary thyroid microcarcinoma. High-quality prospective studies are needed to better evaluate the comparative effectiveness of immediate thyroidectomy versus observation for elderly patients with papillary thyroid microcarcinoma.
比较非手术治疗与手术治疗对老年甲状腺微小乳头状癌患者的疗效。
研究队列包括1988年至2009年间在国家癌症研究所的监测、流行病学和最终结果18数据库中确诊为甲状腺微小乳头状癌的2323例老年患者（年龄65岁及以上）。
非手术患者的五年总生存率为23%，而手术患者为91%（p<0.0001）。未经调整的分析显示，手术患者的生存率明显高于非手术患者（风险比=0.06；p<0.0001）。倾向评分分析也显示，手术患者的生存率明显高于非手术患者（风险比=0.11；p<0.0001）。
甲状腺切除术似乎能为老年甲状腺微小乳头状癌患者带来生存益处。需要高质量的前瞻性研究来更好地评估即刻甲状腺切除术与观察对老年甲状腺微小乳头状癌患者的相对疗效。
