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73 例甲状腺癌伴大体血管侵犯行甲状腺切除术的狗狗的预后和术后并发症。

Outcome and postoperative complications in 73 dogs with thyroid carcinoma with gross vascular invasion managed with thyroidectomy.

机构信息

Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri, USA.

Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.

出版信息

Vet Comp Oncol. 2021 Dec;19(4):685-696. doi: 10.1111/vco.12739. Epub 2021 Jun 4.

Abstract

Excellent outcomes have been reported following thyroidectomy for thyroid carcinoma in dogs, but outcomes for thyroid carcinomas with gross vascular invasion are poorly described. This study describes the clinical outcomes and complications in dogs with thyroid carcinomas with gross vascular invasion undergoing thyroidectomy. Medical records of dogs that underwent thyroidectomy between January 1st 2010 and December 31st 2019 were reviewed at 10 hospitals. Signalment, diagnostic data, primary and adjuvant treatments performed, and outcome were abstracted. Survival was calculated using Kaplan-Meier analysis. Multiple logistic regression was used to identify variables associated with disease-specific survival. Seventy-three dogs were included, of which 58 underwent unilateral thyroidectomy and 15 underwent bilateral thyroidectomy. Complications were reported in five dogs (three major, two minor; 6.8%) intraoperatively and 12 dogs (two major leading to death, 10 minor; 16.4%) postoperatively. Seven (9.6%) dogs developed locoregional recurrence at a median of 238 days postoperatively (range: 15-730 days). Distant metastasis was suspected or confirmed in nine dogs (12.3%) at a median of 375 days postoperatively (range: 50-890 days). Twenty-seven dogs (37%) received adjuvant therapy (chemotherapy: n = 21; radiotherapy: n = 6). Thirty-nine dogs were euthanized or died, with 20 deaths related to disease (n = 10) or of unknown cause (n = 10), 19 due to unrelated causes, and nine lost to follow-up. Median overall and disease-specific survival were 621 days and not reached respectively. One-year disease-specific survival rate was 82.5%. No variables were associated with disease-specific survival in our dataset. Surgery may be considered for loco-regional therapy in dogs with thyroid carcinoma with gross vascular invasion.

摘要

甲状腺癌患者行甲状腺切除术的预后通常较好,但伴有肉眼血管侵犯的甲状腺癌的预后描述较差。本研究描述了行甲状腺切除术的伴有肉眼血管侵犯的甲状腺癌犬的临床结局和并发症。在 10 家医院回顾了 2010 年 1 月 1 日至 2019 年 12 月 31 日期间行甲状腺切除术的犬的病历。提取了特征、诊断数据、进行的主要和辅助治疗以及结局。使用 Kaplan-Meier 分析计算生存率。使用多因素逻辑回归分析确定与疾病特异性生存相关的变量。共纳入 73 只犬,其中 58 只接受了单侧甲状腺切除术,15 只接受了双侧甲状腺切除术。术中报告 5 只(3 只严重,2 只轻微;6.8%)和术后报告 12 只(2 只严重导致死亡,10 只轻微;16.4%)出现并发症。7 只(9.6%)犬在术后中位时间 238 天(范围:15-730 天)时发生局部复发。9 只(12.3%)犬在术后中位时间 375 天(范围:50-890 天)时怀疑或确诊远处转移。27 只(37%)犬接受了辅助治疗(化疗:n=21;放疗:n=6)。39 只犬被安乐死或死亡,其中 20 例死亡与疾病(n=10)或未知原因(n=10)有关,19 例与无关原因有关,9 例失访。中位总生存和疾病特异性生存分别为 621 天和未达到。1 年疾病特异性生存率为 82.5%。在我们的数据集中,没有变量与疾病特异性生存相关。对于伴有肉眼血管侵犯的甲状腺癌犬,手术可能可作为局部治疗的一种选择。

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