Zhantansi Outpatient, Central Medical District of Chinese PLA General Hospital, Beijing, China.
College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.
Horm Metab Res. 2023 Dec;55(12):855-868. doi: 10.1055/a-2177-3413. Epub 2023 Oct 9.
This cohort study evaluated the associations of different treatments with the prognosis of follicular variant papillary thyroid carcinoma (FVPTC) and classical papillary thyroid carcinoma (CPTC) patients. The data of 69034 PTC patients were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. The 5-year mortality of CPTC and FVPTC patients receiving surgery, radiation and combination therapy were compared. The univariable and multivariable cox proportional risk models explored the associations between different treatments and the 5-year mortality in CPTC and FVPTC patients. The 5-year mortality of CPTC patients was 2.81% and FVPTC patients was 2.47%. Compared with CPTC receiving lobectomy and/or isthmectomy, those not receiving surgery were associated with increased risk of 5-year mortality [Hazards ratio (HR)=3.27, 95% confidence interval (CI): 2.55-4.20] while total thyroidectomy was correlated with reduced risk of 5-year mortality (HR=0.67, 95%CI: 0.55-0.80). Radioactive iodine (RAI) was linked with decreased risk of 5-year mortality in CPTC patients (HR=0.57, 95%CI: 0.50-0.65). CPTC patients undergoing both surgery and radiation were related to decreased risk of 5-year mortality compared with those receiving surgery only (HR=0.55, 95%CI: 0.48-0.63). CPTC patients receiving neither surgery nor radiation (HR=4.53, 95%CI: 3.72-5.51) or those receiving radiation (HR=1.98, 95%CI: 1.13-3.48) were correlated with elevated risk of 5-year mortality. The elevated risk of 5-year mortality in FVPTC patients was reduced in those undergoing RAI (HR=0.63, 95%CI: 0.51-0.76). In conclusion, combination therapy was associated with decreased risk of 5-year mortality in CPTC and FVPTC patients, which might provide a reference for the management of these patients.
这项队列研究评估了不同治疗方法与滤泡状甲状腺癌变异型（FVPTC）和经典型甲状腺癌（CPTC）患者预后的关系。从监测、流行病学和最终结果（SEER）数据库中检索了 69034 例 PTC 患者的数据。比较了接受手术、放疗和联合治疗的 CPTC 和 FVPTC 患者的 5 年死亡率。单变量和多变量 Cox 比例风险模型探讨了不同治疗方法与 CPTC 和 FVPTC 患者 5 年死亡率之间的关系。CPTC 患者的 5 年死亡率为 2.81%，FVPTC 患者的 5 年死亡率为 2.47%。与接受甲状腺叶切除术和/或峡部切除术的 CPTC 患者相比，未接受手术的患者 5 年死亡率增加的风险较高[风险比（HR）=3.27，95%置信区间（CI）：2.55-4.20]，而全甲状腺切除术与 5 年死亡率降低相关（HR=0.67，95%CI：0.55-0.80）。放射性碘（RAI）与 CPTC 患者 5 年死亡率降低相关（HR=0.57，95%CI：0.50-0.65）。与仅接受手术的 CPTC 患者相比，同时接受手术和放疗的患者 5 年死亡率降低（HR=0.55，95%CI：0.48-0.63）。既未接受手术也未接受放疗的 CPTC 患者（HR=4.53，95%CI：3.72-5.51）或仅接受放疗的 CPTC 患者（HR=1.98，95%CI：1.13-3.48）5 年死亡率增加的风险升高。FVPTC 患者 5 年死亡率升高的风险在接受 RAI 治疗后降低（HR=0.63，95%CI：0.51-0.76）。总之，联合治疗与 CPTC 和 FVPTC 患者 5 年死亡率降低相关，可为这些患者的治疗提供参考。
