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阿拉伯联合酋长国甲状腺癌患者放射性碘使用量下降但甲状腺全切除术未减少——一项回顾性研究

Decline in radioiodine use but not total thyroidectomy in thyroid cancer patients treated in the United Arab Emirates - A retrospective study.

作者信息

Azhar Malik, Aziz Faisal, Almuhairi Salama, Alfelasi Mohammad, Elhouni Ali, Syed Rizwan, Al-Shamsi Humaid O, Aldahmani Khaled M

机构信息

Endocrine Division, Tawam Hospital, Al Ain, United Arab Emirates.

Departments of Medicine, College of Medicine and Health Science, UAE University, United Arab Emirates.

出版信息

Ann Med Surg (Lond). 2021 Mar 4;64:102203. doi: 10.1016/j.amsu.2021.102203. eCollection 2021 Apr.

Abstract

OBJECTIVES

To assess the trend of clinicopathological features and treatment modalities in patients with thyroid cancer (TC) in the largest oncology center in the United Arab Emirates (UAE).

METHODS

A retrospective analysis of patients with TC presenting to a tertiary care hospital in Al Ain, UAE between September 2008 and December 2018 identified using ICD 9 & 10 codes was performed. Data on demographics, histopathology, surgical extent, and use of Radioiodine (RAI) were extracted. Exact logistic and ordinal logistic regressions were performed to analyze the annual trend in features and management of TC, and logistic regression analysis was performed to identify predictors of total thyroidectomy and RAI use.

RESULTS

A total of 762 patients were included in the analysis (mean age: 39.6 ± 12.6 years, 45 (60%) women). The majority (92.2%) were diagnosed with papillary thyroid cancer (PTC) and 83.9% had tumor size of <4 cm. All patients underwent surgery (93.8% total thyroidectomy, 6.2% lobectomy) and 77.4% received RAI therapy overall with a significant (p < 0.001) decline from 100% in 2008 to 60% in 2018. In multivariate analysis, nationality, and lymph node (LN) involvement were significant predictors of total thyroidectomy, while nationality, LNs, year of diagnosis, and tumor size significantly predicted RAI use.

CONCLUSION

Most patients in our cohort were diagnosed with localized PTC with no significant change in the extent of surgical approach but a substantial decline in RAI therapy administration over time. Nationality and LN involvement were significant predictors of surgical extent and RAI use.

摘要

目的

评估阿拉伯联合酋长国(阿联酋)最大的肿瘤中心甲状腺癌(TC)患者的临床病理特征及治疗方式的变化趋势。

方法

对2008年9月至2018年12月期间在阿联酋艾因市一家三级护理医院就诊的TC患者进行回顾性分析,通过国际疾病分类第9版和第10版代码进行识别。提取患者的人口统计学、组织病理学、手术范围及放射性碘(RAI)使用情况等数据。采用精确逻辑回归和有序逻辑回归分析TC特征及治疗的年度变化趋势,并进行逻辑回归分析以确定全甲状腺切除术和RAI使用的预测因素。

结果

共762例患者纳入分析(平均年龄:39.6±12.6岁,45例(60%)为女性)。大多数(92.2%)被诊断为乳头状甲状腺癌(PTC),83.9%的肿瘤大小<4cm。所有患者均接受了手术(93.8%为全甲状腺切除术,6.2%为叶切除术),总体77.4%接受了RAI治疗,从2008年的100%显著下降至2018年的60%(p<0.001)。多因素分析中,国籍和淋巴结(LN)受累是全甲状腺切除术的显著预测因素,而国籍、LN、诊断年份和肿瘤大小显著预测RAI的使用。

结论

我们队列中的大多数患者被诊断为局限性PTC,手术方式范围无显著变化,但随着时间推移RAI治疗的应用大幅下降。国籍和LN受累是手术范围和RAI使用的显著预测因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57fb/7970029/5212e1dfb922/gr1.jpg

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