Leite Ana Kober N, Cavalheiro Beatriz G, Kulcsar Marco Aurélio, Hoff Ana de Oliveira, Brandão Lenine G, Cernea Claudio Roberto, Matos Leandro L
Divisão de Cirurgia de Cabeça e Pescoço, Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brasil.
Departamento de Endocrinologia, Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brasil.
Arch Endocrinol Metab. 2017 May-Jun;61(3):222-227. doi: 10.1590/2359-3997000000261. Epub 2017 Mar 27.
The present study describes the clinical and tumor characteristics of patients that died from differentiated thyroid cancer and reports on the cause and circumstances of death in these cases.
Retrospective analysis of all the differentiated thyroid cancer (DTC) related deaths at a single institution over a 5-year period, with a total of 33 patients.
Most of the patients were female (63.6%), with a mean age at diagnosis of 58.2 years. The most common histologic type was papillary (66.7%) and 30.3% were follicular. The distribution according to the TNM classification was: 15.4% of T1; 7.7% T2; 38.4% T3; 19.2% of T4a and 19.2% of T4b. Forty-four percent of cases were N0; 20% N1a and 36.6% of N1b. Twelve patients were considered non-responsive to radioiodine. Only one of the patients did not have distant metastases. The most common metastatic site was the lung in 69.7%. The majority of deaths were due to pulmonary complications related to lung metastases (17 patients, 51.5%), followed by post-operative complications in 5 cases, neurological disease progression in 3 cases, local invasion and airway obstruction in one patient. Median survival between diagnosis and death was reached in 49 months while between disease progression and death it was at 22 months.
Mortality from DTC is extremely rare but persists, and the main causes of death derive from distant metastasis, especially respiratory failure due to lung metastasis. Once disease progression is established, median survival was only 22 months.
本研究描述了死于分化型甲状腺癌患者的临床和肿瘤特征，并报告了这些病例的死亡原因和情况。
对某单一机构5年内所有与分化型甲状腺癌（DTC）相关的死亡病例进行回顾性分析，共有33例患者。
大多数患者为女性（63.6%），诊断时的平均年龄为58.2岁。最常见的组织学类型是乳头状癌（66.7%），滤泡状癌占30.3%。根据TNM分类的分布情况为：T1占15.4%；T2占7.7%；T3占38.4%；T4a占19.2%，T4b占19.2%。44%的病例为N0；20%为N1a，36.6%为N1b。12例患者被认为对放射性碘无反应。只有1例患者没有远处转移。最常见的转移部位是肺，占69.7%。大多数死亡是由于与肺转移相关的肺部并发症（17例，51.5%），其次是术后并发症5例，神经疾病进展3例，1例患者出现局部侵犯和气道阻塞。诊断至死亡的中位生存期为49个月，而疾病进展至死亡的中位生存期为22个月。
DTC导致的死亡极为罕见但仍有发生，主要死亡原因源于远处转移，尤其是肺转移导致的呼吸衰竭。一旦疾病进展确立，中位生存期仅为22个月。
