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放射性碘治疗并未改善甲状腺 Hurthle 细胞癌的癌症特异性生存。

Radioactive Iodine Therapy Does not Improve Cancer-specific Survival in Hürthle Cell Carcinoma of the Thyroid.

机构信息

Department of Thyroid & Parathyroid Surgery; Laboratory of Thyroid and Parathyroid Disease, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

J Clin Endocrinol Metab. 2022 Nov 23;107(11):3144-3151. doi: 10.1210/clinem/dgac448.

Abstract

CONTEXT

It is unclear whether radioactive iodine (RAI) therapy could improve cancer-specific survival (CSS) in patients with Hürthle cell carcinoma (HCC) of the thyroid.

OBJECTIVE

To investigate the effect of RAI on CSS in HCC patients.

METHODS

HCC patients who underwent total thyroidectomy (TT) were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2018. The Kaplan-Meier method and the Cox proportional hazards regression model were used to evaluate CSS. Propensity score-matched (PSM) analyses were performed to control the influence of potential confounders.

RESULTS

A total of 2279 patients were identified. RAI treatment was not significantly associated with improved CSS in overall or PSM cohort. Subgroup analyses indicated similar results, even in patients with aggressive features such as age 55 years or older, tumor size greater than 40 mm, distant disease in SEER staging, extrathyroidal extension, and lymph node metastases (all P > .05).

CONCLUSION

RAI has no statistically significant influence on the CSS in HCC patients. This information may aid in decision-making for RAI therapy in these patients.

摘要

背景

目前尚不清楚放射性碘(RAI)治疗是否能提高甲状腺 Hurthle 细胞癌(HCC)患者的癌症特异性生存(CSS)。

目的

研究 RAI 对 HCC 患者 CSS 的影响。

方法

从 2000 年至 2018 年的监测、流行病学和最终结果(SEER)数据库中确定接受甲状腺全切除术(TT)的 HCC 患者。采用 Kaplan-Meier 方法和 Cox 比例风险回归模型评估 CSS。进行倾向评分匹配(PSM)分析以控制潜在混杂因素的影响。

结果

共确定了 2279 例患者。RAI 治疗与总体或 PSM 队列中 CSS 的改善均无显著相关性。亚组分析表明了类似的结果,即使在年龄 55 岁或以上、肿瘤大小大于 40mm、SEER 分期有远处疾病、甲状腺外侵犯和淋巴结转移等侵袭性特征的患者中也是如此(均 P>0.05)。

结论

RAI 对 HCC 患者的 CSS 无统计学显著影响。这些信息可能有助于对这些患者的 RAI 治疗做出决策。

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