Zhou Bo, Huang Hui, Xu Zhengang, Wu Yuehuang, Wang Xiaolei
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2017 Jun 20;39(3):383-388. doi: 10.3881/j.issn.1000-503X.2017.03.014.
Objective To determine the long-term outcomes of cN0 papillary thyroid carcinoma without elective central compartment neck dissection. Methods The clinical data of 180 patients with clinically lymph node negative papillary thyroid carcinoma who were treated in our center between 2000 and 2005 were retrospectively analyzed. All of these patients did not receive elective central compartment neck dissection. Clinicopathological characteristics including gender,age,surgical range,pathologic type,tumor size,and extrathyroidal extension(ETE)or not were collected. Results After a median follow-up period of 90 months,only one patient died of stroke without tumor. Sixteen patients had tumor recurrence:seven patients had a recurrent disease in residual thyroid tissue,two in the thyroid bed,six in central compartment,eight in lateral cervical compartment,and one in lung. The 10-year overall survival,disease-specific survival,and recurrence-free survival was 99.4%,100%,and 87.9%,respectively. The 10-year accumulative lymph node recurrence rate in central compartment and lateral compartment was 7.8% and 7.0%,respectively. ETE was an independent risk factor for central compartment lymph node recurrence. Male gender(P=0.010)and ETE(P=0.028)were independent risk factors for lateral compartment lymph node recurrence. Conclusions The prognosis of patients with cN0 papillary thyroid carcinoma without elective central compartment neck dissection is good after ten years of follow-up. Male gender and ETE are independent risk factors for lateral compartment lymph node recurrence.
目的 确定未行选择性中央区颈淋巴结清扫术的cN0期甲状腺乳头状癌的长期预后。方法 回顾性分析2000年至2005年在本中心接受治疗的180例临床淋巴结阴性甲状腺乳头状癌患者的临床资料。所有这些患者均未接受选择性中央区颈淋巴结清扫术。收集患者的临床病理特征，包括性别、年龄、手术范围、病理类型、肿瘤大小以及是否存在甲状腺外侵犯（ETE）。结果 中位随访90个月后，仅1例患者非肿瘤原因死于中风。16例患者出现肿瘤复发：7例患者在残余甲状腺组织复发，2例在甲状腺床复发，6例在中央区复发，8例在侧颈部复发，1例在肺部复发。10年总生存率、疾病特异性生存率和无复发生存率分别为99.4%、100%和87.9%。中央区和侧颈部10年累积淋巴结复发率分别为7.8%和7.0%。ETE是中央区淋巴结复发的独立危险因素。男性（P=0.010）和ETE（P=0.028）是侧颈部淋巴结复发的独立危险因素。结论 对未行选择性中央区颈淋巴结清扫术的cN0期甲状腺乳头状癌患者进行10年随访后的预后良好。男性和ETE是侧颈部淋巴结复发的独立危险因素。
