Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, 54, Shogoin Kawahara-cho, Sakyo-ku, Kyoto-shi, Kyoto, 606-8507, Japan.
Department of Radiation Oncology, Shizuoka City Shizuoka Hospital, 10-93, Ote-machi, Aoi-ku, Shizuoka-shi, Shizuoka, 420-8630, Japan.
Sci Rep. 2023 Jul 4;13(1):10795. doi: 10.1038/s41598-023-37899-z.
This study aimed to assess recurrence-free survival (RFS) rates and recurrence-related factors of patients who received adjuvant therapy (AT) with radioactive iodine (RAI) for differentiated thyroid cancer (DTC) following thyroidectomy. We evaluated 284 patients who underwent AT between January 2011 and July 2020 at our hospital. Recurrence was defined as visible recurrent lesions on image analysis or need for repeat surgery with pathologically confirmed recurrent lesions. RFS rate and prognostic factors were statistically evaluated. The median observation period was 30.2 months (range, 5.7-294 months). Overall, 192 patients were female and 92 were male, and the median age was 54 years (range, 9-85 years). Initial assessment revealed 39 recurrence cases. The 3-year RFS rate was 85.8% (95% confidence interval: 81.1-90.9%). Univariate analysis revealed that histology (except for papillary carcinoma), Tg level > 4 ng/dL before AT, and AT result significantly exacerbated the RFS rate. In multivariate analysis, histology and AT result were also important contributors to the worsening RFS rate. Results of AT can be determined relatively early and are important in predicting future recurrence in patients with DTC. Increasing the success rate of AT may lead to an improved prognosis.
本研究旨在评估接受放射性碘（RAI）辅助治疗（AT）的分化型甲状腺癌（DTC）患者在甲状腺切除术后的无复发生存（RFS）率和与复发相关的因素。我们评估了 2011 年 1 月至 2020 年 7 月期间在我院接受 AT 的 284 例患者。复发定义为图像分析可见复发病灶或需要重复手术并经病理证实复发病灶。统计评估 RFS 率和预后因素。中位观察期为 30.2 个月（范围，5.7-294 个月）。总体而言，192 例患者为女性，92 例为男性，中位年龄为 54 岁（范围，9-85 岁）。初始评估发现 39 例复发病例。3 年 RFS 率为 85.8%（95%置信区间：81.1-90.9%）。单因素分析显示，组织学（除乳头状癌外）、AT 前 Tg 水平>4ng/dL 和 AT 结果显著恶化 RFS 率。多因素分析显示，组织学和 AT 结果也是 RFS 率恶化的重要因素。AT 的结果可以相对较早确定，对于预测 DTC 患者的未来复发具有重要意义。提高 AT 的成功率可能会改善预后。
