Department of Otorhinolaryngology-Head & Neck Surgery, Hallym University College of Medicine, Anyang, Korea.
Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang, Korea.
PLoS One. 2018 Mar 29;13(3):e0195074. doi: 10.1371/journal.pone.0195074. eCollection 2018.
The purpose of this study is to evaluate the risk of stroke (hemorrhagic or ischemic) after neck dissection in thyroid cancer patients in Korea using national cohort data.
Using the national cohort study from the Korean Health Insurance Review and Assessment Service, patients with neck dissection for thyroid cancer (1,041) and control participants (4,164) were selected and matched 1:4 (age, gender, income, and region of residence). The Chi-square test, Fischer's exact test, and the Cox-proportional hazard model were used. The Cox-proportional analysis used a crude model and an adjusted model for age, gender, income, region of residence, hypertension, diabetes, dyslipidemia.
None of the participants had suffered hemorrhagic stroke in the neck dissection group, while 0.3% (13/4,164) of participants had suffered hemorrhagic stroke in the control group (P = 0.085). In total, 0.8% (8/1,041) of participants had suffered an ischemic stroke in the neck dissection group, and 0.7% (31/4,133) of participants had suffered an ischemic stroke in the control group (P = 0.936). The adjusted hazard ratio for ischemic stroke after neck dissection was 1.06 (95% confidence interval [CI] = 0.49-2.31, P = 0.884).
The risk of hemorrhagic or ischemic stroke was not higher in thyroid cancer patients who underwent neck dissection than that in the matched control group.
本研究旨在使用韩国全国队列数据评估甲状腺癌患者行颈部清扫术后发生中风(出血性或缺血性)的风险。
利用韩国健康保险审查与评估服务的全国队列研究,选择了甲状腺癌行颈部清扫术的患者(1041 例)和对照组患者(4164 例),并按照 1:4(年龄、性别、收入和居住地区域)进行匹配。采用卡方检验、Fisher 确切检验和 Cox 比例风险模型进行分析。Cox 比例分析采用了未调整和调整年龄、性别、收入、居住地区域、高血压、糖尿病、血脂异常的模型。
在颈部清扫组中,无参与者发生出血性中风,而在对照组中,有 0.3%(13/4164)的参与者发生出血性中风(P=0.085)。在颈部清扫组中,共有 0.8%(8/1041)的参与者发生缺血性中风,而在对照组中,有 0.7%(31/4133)的参与者发生缺血性中风(P=0.936)。调整后的颈部清扫术后缺血性中风的风险比为 1.06(95%置信区间[CI]为 0.49-2.31,P=0.884)。
与匹配的对照组相比,行颈部清扫术的甲状腺癌患者发生出血性或缺血性中风的风险没有增加。