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高龄对散发性甲状腺髓样癌临床表现及预后的影响

Impact of Advanced Age on the Clinical Presentation and Outcome of Sporadic Medullary Thyroid Carcinoma.

作者信息

Matrone Antonio, Gambale Carla, Prete Alessandro, Piaggi Paolo, Cappagli Virginia, Bottici Valeria, Romei Cristina, Ciampi Raffaele, Torregrossa Liborio, De Napoli Luigi, Molinaro Eleonora, Materazzi Gabriele, Basolo Fulvio, Elisei Rossella

机构信息

Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy.

National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ 85016, USA.

出版信息

Cancers (Basel). 2020 Dec 30;13(1):94. doi: 10.3390/cancers13010094.

Abstract

Sporadic medullary thyroid carcinoma (MTC) is a rare malignancy with a heterogeneous clinical course. Several potential prognostic factors have been investigated, but the impact of some of these is controversial, such as age at diagnosis. We evaluated the data of 432 sporadic MTC patients followed-up for a median of 7.4 years. Patients were divided and compared according to their age at diagnosis in group A (<65 years-n = 338, 78.2%) and group B (≥65 years-n = 94, 21.8%). No differences were detected between the two groups. Median follow-up time was significantly longer in patients <65 than ≥65 years. We observed 41 (9.5%) cancer-related death events. The death rate was similar between the two age groups. However, the Kaplan Meier curve showed a longer survival time for younger patients compared to older patients [HR 2.5 (CI 95%: 1.27-4.94), < 0.01]. Nevertheless, no differences in the aggressiveness of the disease at presentation and in the number and type of treatments performed were found in the two subgroups of dead patients. In patients with sporadic MTC, age at diagnosis did not correlate with any clinical and pathological features. Cancer-related death events are similar in older and younger patients, but survival time is longer in the younger.

摘要

散发性甲状腺髓样癌(MTC)是一种临床病程各异的罕见恶性肿瘤。已经对多种潜在的预后因素进行了研究,但其中一些因素的影响存在争议,例如诊断时的年龄。我们评估了432例散发性MTC患者的数据,这些患者的中位随访时间为7.4年。根据诊断时的年龄将患者分为A组(<65岁,n = 338,78.2%)和B组(≥65岁,n = 94,21.8%)并进行比较。两组之间未检测到差异。<65岁患者的中位随访时间明显长于≥65岁的患者。我们观察到41例(9.5%)与癌症相关的死亡事件。两个年龄组的死亡率相似。然而,Kaplan Meier曲线显示年轻患者的生存时间比老年患者长[风险比2.5(95%置信区间:1.27 - 4.94),P < 0.01]。尽管如此,在死亡患者的两个亚组中,疾病初发时的侵袭性以及所进行治疗的数量和类型均未发现差异。在散发性MTC患者中,诊断时的年龄与任何临床和病理特征均无相关性。老年和年轻患者与癌症相关的死亡事件相似,但年轻患者的生存时间更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1027/7795457/a5bc09711721/cancers-13-00094-g001.jpg

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