经皮导丝定位与手术切除治疗甲状腺癌术后隐匿性复发：一项符合 STROBE 指南的回顾性队列研究。

Wire-guided localization and surgical resection of non-palpable recurrent of thyroid carcinoma: A STROBE-compliant, retrospective cohort study.

机构信息

Departamento de Cabeza y Cuello, Mexico City, Mexico.

Subdirector de Investigación Clínica, Mexico City, Mexico.

出版信息

Eur J Surg Oncol. 2024 Jan;50(1):107306. doi: 10.1016/j.ejso.2023.107306. Epub 2023 Nov 29.

DOI:10.1016/j.ejso.2023.107306

PMID:38048725

Abstract

BACKGROUND

Information on hook-wire guided (HWG) surgery for non-palpable thyroid carcinoma (TC), locoregional-recurrent disease (LRRD) is scarce. We analyze the results of HWG resection compared with the traditional procedure.

METHODS

Cohort study performed between January 2016 and December 2020. Patients with TC and non-palpable LRRD were included. A "Standard cohort", patients with non-HWG resection and "HWG cohort", with HWG resection of LRRD were defined. Surgical morbidity, re-recurrent/progressive disease (RRD), and re-recurrence-free survival (RRFS) were defined.

RESULTS

43 and 23 patients were assigned to the Standard or HWG cohorts, respectively. Complications occurred in 28 % and 17.3 % of cases, in control or HWG cohorts, respectively. HWG cohort, size of primary TC, I dose >150 mCi, and thyroglobulin level >1 ng/ml at detection of LRRD were associated with RRD. HWG cohort, thyroglobulin level at LRRD, I treatment, and dose were associated with RRFS.

CONCLUSIONS

HWG surgery of non-palpable TC LRRD had improved results regarding surgical morbidity, RRD, and RRFS.

摘要

背景

针对触诊阴性甲状腺癌（TC）、局部区域复发性疾病（LRRD）的钩丝引导（HWG）手术信息有限。我们分析了 HWG 切除术与传统手术的结果。

方法

这是一项在 2016 年 1 月至 2020 年 12 月期间进行的队列研究，纳入了 TC 伴非触诊 LRRD 的患者。将“标准组”（未接受 HWG 切除术的患者）和“HWG 组”（LRRD 行 HWG 切除术的患者）定义为非 HWG 切除术和 HWG 切除术。定义了手术发病率、复发性/进展性疾病（RRD）和无复发生存率（RRFS）。

结果

分别有 43 例和 23 例患者被分配到标准组或 HWG 组。对照组和 HWG 组的并发症发生率分别为 28%和 17.3%。HWG 组中，原发 TC 大小、I 剂量>150mCi 和 LRRD 时甲状腺球蛋白水平>1ng/ml 与 RRD 相关。HWG 组中，LRRD 时的甲状腺球蛋白水平、I 治疗和剂量与 RRFS 相关。