Department of Thyroid Surgery, The 1st Hospital of Jilin University, Changchun, 130021, People's Republic of China.
World J Surg. 2017 Dec;41(12):3139-3146. doi: 10.1007/s00268-017-4134-0.
We aimed to carry out a retrospective study from a single institution to determine whether radioactive iodine (RAI) ablation decreases the risk of recurrence of papillary thyroid microcarcinoma (PTMC) patients that presented with lateral lymph node metastasis (LLNM).
We retrospectively analyzed a total of 6361 consecutive PTMC patients who initially underwent surgery for the treatment of thyroid carcinoma at the First Hospital of Jilin University, between January 2005 and February 2015. Altogether, 137 patients with PTMC with LLNM have been enrolled in our study.
The disease-free survival period was significantly shorter for the RAI (-) patients than for the RAI (+) patients (p = 0.0074 by the log-rank test). The disease-free survival rates at 5 and 10 years were 93.02 and 87.5%, respectively, in the RAI (-) group and 100 and 96.81%, respectively, in the RAI (+) group. CLNM ratio and LLNM ratio were factors identified for multivariate analysis by Cox's proportional hazards method yielding risk ratios of 7.281 [CI 1.804-17.554; p = 0.010] and 1.157 [CI 1.0125-9.381; p = 0.048] in the RAI (-) group.
Taken together, RAI may be beneficial for PTMC with LLNM, especially when CLNM ratio or LLNM ratio was greater than 0.5.
我们旨在进行一项单中心回顾性研究,以确定放射性碘(RAI)消融是否降低伴有侧颈部淋巴结转移(LLNM)的甲状腺微小乳头状癌(PTMC)患者复发的风险。
我们回顾性分析了 2005 年 1 月至 2015 年 2 月期间在吉林大学第一医院接受甲状腺癌初始手术治疗的 6361 例连续 PTMC 患者。共有 137 例伴有 LLNM 的 PTMC 患者被纳入本研究。
RAI(-)患者的无病生存期明显短于 RAI(+)患者(对数秩检验,p=0.0074)。RAI(-)组 5 年和 10 年无病生存率分别为 93.02%和 87.5%,RAI(+)组分别为 100%和 96.81%。Cox 比例风险回归分析显示 CLNM 比值和 LLNM 比值是多因素分析的因素,其风险比分别为 7.281[CI 1.804-17.554;p=0.010]和 1.157[CI 1.0125-9.381;p=0.048]。
综上所述,RAI 可能对伴有 LLNM 的 PTMC 有益,尤其是 CLNM 比值或 LLNM 比值大于 0.5 时。