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甲状腺癌肝转移和胰腺转移切除术后的长期预后:文献系统评价

Long-Term Outcomes After Hepatic and Pancreatic Resections for Metastases from Thyroid Cancer: a Systematic Review of the Literature.

作者信息

Paspala Anna, Kostakis Ioannis D, Gaitanidis Apostolos, Prodromidou Anastasia, Schizas Dimitrios, Machairas Nikolaos

机构信息

3rd Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Rimini 1, 12462, Chaidari, Greece.

1st Department of Surgery, Metaxa Memorial Hospital, Piraeus, Greece.

出版信息

J Gastrointest Cancer. 2019 Mar;50(1):9-15. doi: 10.1007/s12029-018-00196-4.

Abstract

PURPOSE

The objective of our systematic review was to evaluate the long-term outcomes of surgical resection as a treatment strategy for liver and pancreatic metastases from thyroid cancer (TC).

METHODS

A systematic search of three electronic databases for articles published up to October 2018 was conducted. All appropriate observational studies and case reports which reported outcomes from patients with TC metastatic to the liver or pancreas were considered eligible for inclusion in the present systematic review.

RESULTS

A total of 15 studies, which comprised of 16 patients that underwent hepatic or pancreatic resection for TC metastasis, were included in the present systematic review; among them, 5 presented with metastasis to the liver, whereas 11 had pancreatic metastatic disease. The median time interval between the initial thyroidectomy and the diagnosis of metastases (either hepatic or pancreatic) was 60 months (SE 23.8, 95% CI 13.3-106.7) for the entire cohort and the mean overall survival was 37.6 months (SE 8, 95% CI 22-53.3). Five patients with pancreatic metastases presented with recurrence whereas no recurrences were noted in patients with liver metastases.

CONCLUSIONS

Surgical resection of liver and pancreatic metastases from TC seems to be a safe and efficient treatment option for selected patients. In that setting, long-term outcomes in patients with resected TCLM are encouraging given the absence of recurrence as reported from the included studies, whereas in the case of TCPM, survival is limited due to advanced disease at diagnosis and recurrence rates.

摘要

目的

我们系统评价的目的是评估手术切除作为甲状腺癌(TC)肝和胰腺转移治疗策略的长期疗效。

方法

对三个电子数据库进行系统检索,以查找截至2018年10月发表的文章。所有报道TC转移至肝脏或胰腺患者结局的适当观察性研究和病例报告均被认为有资格纳入本系统评价。

结果

本系统评价共纳入15项研究,包括16例因TC转移而接受肝或胰腺切除的患者;其中,5例为肝转移,11例为胰腺转移疾病。整个队列中,初次甲状腺切除与转移(肝或胰腺)诊断之间的中位时间间隔为60个月(标准误23.8,95%置信区间13.3 - 106.7),平均总生存期为37.6个月(标准误8,95%置信区间22 - 53.3)。5例胰腺转移患者出现复发,而肝转移患者未观察到复发。

结论

对于部分患者,手术切除TC的肝和胰腺转移似乎是一种安全有效的治疗选择。在这种情况下,鉴于纳入研究报道的无复发现象,接受TCLM切除患者的长期疗效令人鼓舞,而对于TCPM,由于诊断时疾病进展和复发率,生存期有限。

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