Au Joshua K, Alonso Jose, Kuan Edward C, Arshi Armin, St John Maie A
1 Department of Head and Neck Surgery, UCLA Medical Center, Los Angeles, California, USA.
2 Head and Neck Cancer Program, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
Otolaryngol Head Neck Surg. 2017 Jul;157(1):25-29. doi: 10.1177/0194599817698436. Epub 2017 Apr 11.
Objectives To analyze the epidemiology and describe the prognostic indicators of patients with primary squamous cell carcinoma of the thyroid. Study Design and Setting Retrospective cohort study based on a national database. Methods The US National Cancer Institute's SEER registry (Surveillance, Epidemiology, and End Results) was reviewed for patients with primary squamous cell carcinoma of the thyroid from 1973 to 2012. Study variables included age, sex, race, tumor size, tumor grade, regional and distant metastases, and treatment modality. Survival measures included overall survival (OS) and disease-specific survival (DSS). Results A total of 199 cases of primary squamous cell carcinoma of the thyroid were identified. Mean age at diagnosis was 68.1 years; 58.3% were female; and 79.4% were white. Following diagnosis, 46.3% of patients underwent surgery; 55.7%, radiation therapy; and 45.8%, surgery with radiation therapy. Kaplan-Meier analysis demonstrated OS and DSS of 16% and 21% at 5 years, respectively. Median survival after diagnosis was 9.1 months. Multivariate Cox regression analysis showed that predictors of OS and DSS included age ( P < .001, P < .001, respectively), tumor grade ( P < .001, P = .001), and tumor size ( P < .001, P = .001). Surgical management was a predictor of OS but not DSS. Conclusion Squamous cell carcinoma of the thyroid is a rare malignancy with a very poor prognosis. Surgical resection confers an overall survival benefit. Age, tumor grade, and tumor size are predictors of OS and DSS.
目的 分析甲状腺原发性鳞状细胞癌患者的流行病学特征并描述其预后指标。研究设计与背景 基于国家数据库的回顾性队列研究。方法 查阅美国国立癌症研究所的监测、流行病学和最终结果（SEER）登记处1973年至2012年期间甲状腺原发性鳞状细胞癌患者的资料。研究变量包括年龄、性别、种族、肿瘤大小、肿瘤分级、区域和远处转移以及治疗方式。生存指标包括总生存期（OS）和疾病特异性生存期（DSS）。结果 共识别出199例甲状腺原发性鳞状细胞癌患者。诊断时的平均年龄为68.1岁；58.3%为女性；79.4%为白人。诊断后，46.3%的患者接受了手术；55.7%接受了放射治疗；45.8%接受了手术加放射治疗。Kaplan-Meier分析显示5年时的OS和DSS分别为16%和21%。诊断后的中位生存期为9.1个月。多变量Cox回归分析表明，OS和DSS的预测因素包括年龄（分别为P <.001，P <.001）、肿瘤分级（P <.001，P =.001）和肿瘤大小（P <.001，P =.001）。手术治疗是OS的预测因素，但不是DSS的预测因素。结论 甲状腺鳞状细胞癌是一种罕见的恶性肿瘤，预后很差。手术切除可带来总生存获益。年龄、肿瘤分级和肿瘤大小是OS和DSS的预测因素。
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