甲状腺髓样癌中声带麻痹的发生率

Incidence of Vocal Cord Paralysis in Medullary Thyroid Cancer.

作者信息

Drozdowski Veronica, Martini Deema, Charous Steven

机构信息

Department of Otolaryngology, Loyola University Medical Center, Maywood, Illinois, USA.

Loyola University - Stritch School of Medicine, Maywood, Illinois, USA.

出版信息

Laryngoscope. 2023 Apr;133(4):890-894. doi: 10.1002/lary.30297. Epub 2022 Jul 14.

DOI:10.1002/lary.30297

PMID:35833484

Abstract

OBJECTIVE

Medullary thyroid cancer (MTC) is a neuroendocrine tumor that comprises 3-5% of all thyroid cancers in the United States. Vocal cord paralysis (VCP) may be due to involvement of the recurrent laryngeal nerve (RLN) preoperatively, or nerve sacrifice during surgery. The purpose of this study was to demonstrate the incidence of VCP in MTC and evaluate whether VCP has an impact on overall survival.

METHODS

This was a retrospective chart review of patients with MTC treated at Loyola University Medical Center from 2007 to 2021. Information on demographics, cancer diagnosis and treatment, laboratory data, and survival were collected.

RESULTS

A total of 79 patients were included in our study. 47 (59.5%) patients were female. The average age at the time of diagnosis was 51.3 years (SD 13.58). VCP was identified in 13 out of 79 (16.5%) patients. There were 71 patients with at least 1-year follow-up with median (Q1, Q3) years of 7.2 (3.9, 11.0). Those with VCP within 1 year had 7.2 (95% CI: 2.3, 22.7) times the risk of death compared to those without (p < 0.001).

CONCLUSION

MTC is a rare thyroid cancer, however, its incidence is on the rise. Our study suggests that the incidence of VCP in these patients appears to be higher than seen in other thyroid malignancies, and VCP is associated with a statistically significant negative impact on survival.

LEVEL OF EVIDENCE

3 Laryngoscope, 133:890-894, 2023.

摘要

目的

甲状腺髓样癌（MTC）是一种神经内分泌肿瘤，在美国所有甲状腺癌中占3%-5%。声带麻痹（VCP）可能是由于术前喉返神经（RLN）受累，或手术中神经被牺牲。本研究的目的是证明MTC中VCP的发生率，并评估VCP是否对总生存期有影响。

方法

这是一项对2007年至2021年在洛约拉大学医学中心接受治疗的MTC患者的回顾性病历审查。收集了有关人口统计学、癌症诊断和治疗、实验室数据及生存期的信息。

结果

我们的研究共纳入79例患者。47例（59.5%）为女性。诊断时的平均年龄为51.3岁（标准差13.58）。79例患者中有13例（16.5%）被诊断为VCP。71例患者至少随访1年，中位（第一四分位数，第三四分位数）随访时间为7.2（3.9，11.0）年。与未发生VCP的患者相比，1年内发生VCP的患者死亡风险高7.2（95%置信区间：2.3，22.7）倍（p<0.001）。