Chatchomchuan Waralee, Thewjitcharoen Yotsapon, Karndumri Krittadhee, Porramatikul Sriurai, Krittiyawong Sirinate, Wanothayaroj Ekgaluck, Vongterapak Somboon, Butadej Siriwan, Veerasomboonsin Veekij, Kanchanapitak Auchai, Rajatanavin Rajata, Himathongkam Thep
Diabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.
Int J Endocrinol. 2021 May 10;2021:9989757. doi: 10.1155/2021/9989757. eCollection 2021.
The prevalence of thyroid cancer is rising worldwide. Although thyroid cancer has a favorable prognosis, up to 20% of patients experienced recurrent disease during the follow-up period. The present study aimed to examine the trend of incidence and factors associated with recurrence and outcomes of papillary thyroid cancer (PTC) in Thai patients over the last 30 years.
We reviewed the clinical data of all patients with PTC who were treated between 1987 and 2019 at Theptarin Hospital. Clinical characteristics, epidemic trend, factors associated with the persistence/recurrence of the disease, overall disease-specific survival rate, and overall disease-free survival rate were analysed.
A total of 235 patients with PTC who were registered between 1987 and 2019 were reviewed. The mean age was 42.5 ± 14.3 years, with a mean follow-up of 9.5 years. Papillary thyroid microcarcinoma (PTMC) was consistently increased and accounted for 21.4% (50/235) of total cases. The American Thyroid Association (ATA) risk stratification was high in 24% of all PTMCs in the last decade, and 16.0% of these patients experienced local recurrence during the follow-up period. Coexistence with Hashimoto's thyroiditis (HT) was found in one-fifth of the patients with PTC and was correlated with a low recurrence rate (HR: 0.16, =0.013). Only age ≥55 years associated with the persistence/recurrence of the disease. The overall disease-free survival and disease-specific survival rates were 77.4% and 98.3%, respectively.
The prognosis of PTC is generally considered favorable. However, approximately one-fourth of patients with PTMC demonstrated more aggressive clinical behavior, particularly in the last decade of the study. Coexistence of HT contributed to a better prognosis.
甲状腺癌在全球的发病率正在上升。尽管甲状腺癌预后良好，但仍有高达20%的患者在随访期间出现疾病复发。本研究旨在探讨过去30年泰国乳头状甲状腺癌（PTC）患者的发病率趋势、复发相关因素及预后情况。
我们回顾了1987年至2019年在Theptarin医院接受治疗的所有PTC患者的临床资料。分析了临床特征、流行趋势、疾病持续/复发相关因素、总体疾病特异性生存率和总体无病生存率。
共回顾了1987年至2019年登记的235例PTC患者。平均年龄为42.5±14.3岁，平均随访时间为9.5年。甲状腺微小乳头状癌（PTMC）持续增加，占总病例的21.4%（50/235）。在过去十年中，所有PTMC中有24%的美国甲状腺协会（ATA）风险分层为高风险，其中16.0%的患者在随访期间出现局部复发。五分之一的PTC患者同时患有桥本甲状腺炎（HT），且复发率较低（HR：0.16，P=0.013）。只有年龄≥55岁与疾病的持续/复发相关。总体无病生存率和疾病特异性生存率分别为77.4%和98.3%。
PTC的预后通常被认为良好。然而，约四分之一的PTMC患者表现出更具侵袭性的临床行为，尤其是在研究的最后十年。HT的并存有助于改善预后。
