肿瘤大小及最小甲状腺外侵犯在甲状腺乳头状癌中的预后价值
Prognostic value of tumor size and minimal extrathyroidal extension in papillary thyroid carcinoma.
作者信息
Shin Chol-Ho, Roh Jong-Lyel, Song Dong Eun, Cho Kyung-Ja, Choi Seung-Ho, Nam Soon Yuhl, Kim Sang Yoon
机构信息
Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
出版信息
Am J Surg. 2020 Oct;220(4):925-931. doi: 10.1016/j.amjsurg.2020.02.020. Epub 2020 Feb 16.
BACKGROUND
Tumour size and extrathyroidal extension (ETE) may impact papillary thyroid carcinoma (PTC) outcomes. We therefore examined the prognostic value of tumour size and ETE for predicting posttreatment recurrence in PTC patients.
METHODS
A total of 2,902 patients who underwent thyroidectomy for previously untreated T1-T3 PTC (7th edition American Joint Committee on Cancer) at our tertiary referral center were included. Univariate and multivariate Cox proportional hazard regression analyses were used to determine significant factors predictive of posttreatment recurrence-free survival (RFS).
RESULTS
In univariate analysis, tumour factors (including tumour size, multifocality, ETE, and lymphovascular invasion), nodal factors (including positive lymph node number, lymph node ratio, and extranodal extension), and MACIS (metastases, age, completeness of resection, invasion, and size) scores were significantly associated with RFS outcomes (P < 0.001). In multivariate analysis, tumour size >4 cm (P < 0.001) and multifocality (P = 0.038) were the independent factors of RFS. Nodal factors and MACIS scores were also independent factors of RFS.
CONCLUSION
Tumour size impacts RFS after thyroidectomy in T1-T3 PTC patients.
背景
肿瘤大小和甲状腺外侵犯（ETE）可能影响甲状腺乳头状癌（PTC）的预后。因此，我们研究了肿瘤大小和ETE对预测PTC患者治疗后复发的预后价值。
方法
纳入在我们的三级转诊中心接受甲状腺切除术治疗既往未经治疗的T1-T3期PTC（美国癌症联合委员会第7版）的2902例患者。采用单因素和多因素Cox比例风险回归分析来确定预测治疗后无复发生存期（RFS）的显著因素。
结果
在单因素分析中，肿瘤因素（包括肿瘤大小、多灶性、ETE和脉管侵犯）、淋巴结因素（包括阳性淋巴结数量、淋巴结比例和结外侵犯）以及MACIS（转移、年龄、切除完整性、侵犯和大小）评分与RFS结局显著相关（P < 0.001）。在多因素分析中，肿瘤大小>4 cm（P < 0.001）和多灶性（P = 0.038）是RFS的独立因素。淋巴结因素和MACIS评分也是RFS的独立因素。
结论
肿瘤大小影响T1-T3期PTC患者甲状腺切除术后的RFS。
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