放射性碘治疗可能无法提高无远处转移滤泡状甲状腺癌患者的疾病特异性生存率：一项倾向评分匹配分析。
Radioactive iodine therapy may not improve disease-specific survival in follicular variant papillary thyroid cancer without distant metastasis: A propensity score-matched analysis.
机构信息
Department of Thyroid & Parathyroid Surgery, West China Hospital, Sichuan University, Chengdu, China.
出版信息
Head Neck. 2021 Jun;43(6):1730-1738. doi: 10.1002/hed.26637. Epub 2021 Feb 9.
BACKGROUND
Whether radioactive iodine (RAI) therapy is effective in improving disease-specific survival (DSS) in patients with follicular variant papillary thyroid cancer (FVPTC) without distant metastasis remains unclear.
METHODS
Patients with FVPTC were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The Kaplan-Meier method and the Cox proportional hazards regression model were used to evaluate DSS. Propensity score-matched analysis was performed to reduce the influence of confounding bias.
RESULTS
RAI did not improve DSS, even in patients with aggressive features such as T4 classification (p = 0.658), extrathyroidal extension (p = 0.083), lateral lymph node metastasis (p = 0.544), and ≥5 metastatic lymph nodes (p = 0.599).
CONCLUSION
RAI did not affect DSS in patients with FVPTC without distant metastases in this SEER database study. Multicenter, prospective studies including recurrence and molecular information should be conducted to comprehensively evaluate the effects of RAI on FVPTC.
背景
放射性碘 (RAI) 治疗是否能提高无远处转移滤泡状甲状腺癌变异型 (FVPTC) 患者的疾病特异性生存 (DSS) 尚不清楚。
方法
本研究从 2004 年至 2015 年的监测、流行病学和最终结果 (SEER) 数据库中确定了 FVPTC 患者。采用 Kaplan-Meier 方法和 Cox 比例风险回归模型评估 DSS。采用倾向评分匹配分析来减少混杂偏差的影响。
结果
RAI 并未改善 DSS，即使在 T4 分类（p = 0.658）、甲状腺外侵犯（p = 0.083）、侧方淋巴结转移（p = 0.544）和≥5 个转移性淋巴结（p = 0.599）等侵袭性特征的患者中也是如此。
结论
在这项 SEER 数据库研究中，RAI 并未影响无远处转移的 FVPTC 患者的 DSS。应开展包括复发和分子信息的多中心前瞻性研究，以全面评估 RAI 对 FVPTC 的影响。
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