Department of Radiation Oncology, Graduate School of Medicine, Juntendo University, Tokyo, Japan.
Department of Radiology, Kanaji Thyroid Hospital, Tokyo, Japan.
Endocrine. 2023 Apr;80(1):79-85. doi: 10.1007/s12020-022-03251-0. Epub 2022 Nov 11.
Papillary thyroid carcinoma (PTC) with other organ invasions is directly related to patient prognosis and quality of life; however, studies on the clinical outcomes of adjuvant radioactive iodine (RAI) for PTC with other organ invasions are limited. This study aimed to clarify the clinical outcomes and prognostic factors for patients with PTC with other organ invasions after adjuvant RAI.
Patients with PTC with other organ invasions without distant metastases who underwent surgery and adjuvant RAI were retrospectively reviewed. We evaluated the initial responses based on the American Thyroid Association guidelines and survival rates. Prognostic factors for locoregional recurrence-free survival (LRRFS) were analyzed.
Between January 2005 and December 2019, 102 patients were included in the study. Their median age was 55 years. The median follow-up duration was 92 months (range; 30-231 months). The excellent response rate after RAI was 42%. The 7-year overall survival, LRRFS, and recurrence-free survival rates were 100%, 75%, and 75%, respectively. Metastatic lymph node size, resection margin status, and post-RAI suppressed thyroglobulin level were the independent prognostic factors for LRRFS.
We demonstrated that 75% of patients with PTC with other organ invasions could achieve long-term survival without recurrence after adjuvant RAI. Future development of effective treatment strategies for large metastatic lymph nodes, gross residual tumors, and high serum thyroglobulin levels is warranted.
甲状腺乳头状癌(PTC)伴有其他器官侵犯与患者的预后和生活质量直接相关;然而,关于伴有其他器官侵犯的 PTC 患者接受辅助放射性碘(RAI)治疗的临床结局的研究有限。本研究旨在阐明伴有其他器官侵犯的 PTC 患者接受辅助 RAI 治疗后的临床结局和预后因素。
回顾性分析了 102 例无远处转移且接受手术和辅助 RAI 治疗的伴有其他器官侵犯的 PTC 患者。我们根据美国甲状腺协会指南评估初始反应和生存率。分析了局部区域无复发生存率(LRRFS)的预后因素。
2005 年 1 月至 2019 年 12 月期间,共有 102 例患者入组。患者的中位年龄为 55 岁。中位随访时间为 92 个月(范围 30-231 个月)。RAI 后的优秀反应率为 42%。7 年总生存率、LRRFS 和无复发生存率分别为 100%、75%和 75%。转移性淋巴结大小、切缘状态和 RAI 后抑制性甲状腺球蛋白水平是 LRRFS 的独立预后因素。
我们证实,75%的伴有其他器官侵犯的 PTC 患者在接受辅助 RAI 后可以长期生存且无复发。需要进一步开发针对大的转移性淋巴结、大体残留肿瘤和高血清甲状腺球蛋白水平的有效治疗策略。