Ji Xiaoyu, Yu Ruonan, Sun Wei, Zhang Ping, Dong Wenwu, Zhang Hao
Department of Thyroid Surgery, The First Hospital of China Medical University, No. 155 Nanjing North Street, Shenyang, Liaoning, 110001, China.
Endocrine. 2025 Feb;87(2):627-634. doi: 10.1007/s12020-024-04010-z. Epub 2024 Sep 23.
Few studies have been conducted on the dynamic survival rates of follicular thyroid cancer (FTC). This study aimed to ascertain how the survival probability of patients with FTC changes over time.
In this retrospective analysis, 10,617 patients diagnosed with FTC between 2000 and 2019 from the Surveillance, Epidemiology, and End Results (SEER) database were included. Actuarial disease-specific survival (DSS) was estimated using the Kaplan-Meier method, and the log-rank test was used for comparisons. The annual hazard of mortality was determined using the hazard function, and the conditional survival (CS) was calculated using the life table method.
A total of 459 (4.3%) patients died of FTC, and the 5-year and 10-year DSS rates were 96.6 ± 0.2% and 94.6 ± 0.3%, respectively. There was a statistically significant difference in the DSS rate between patients with different SEER combined summary stages (P < 0.001). The annual hazard curve for cancer mortality in the entire study cohort displayed a steep downward trend with a slight peak at 2.5 years after diagnosis, followed by a gradual decline. Patients with distant metastases exhibited a higher mortality hazard curve and more notable declining trend. CS demonstrated an upward trend across the entire study population, with the most pronounced trend in patients with distant metastases.
Prognosis improved over time in a stage-dependent manner in patients with FTC after diagnosis. The most significant improvement was observed in the patients with distant metastases. Notably, dynamic survival estimations, such as death hazard and conditional survival analysis, provide more precise survival projections than traditional survival analysis for FTC survivors.
关于滤泡状甲状腺癌(FTC)动态生存率的研究较少。本研究旨在确定FTC患者的生存概率如何随时间变化。
在这项回顾性分析中,纳入了2000年至2019年期间从监测、流行病学和最终结果(SEER)数据库中诊断为FTC的10617例患者。采用Kaplan-Meier方法估计精算疾病特异性生存率(DSS),并使用对数秩检验进行比较。使用风险函数确定年度死亡风险,并使用生命表法计算条件生存率(CS)。
共有459例(4.3%)患者死于FTC,5年和10年DSS率分别为96.6±0.2%和94.6±0.3%。不同SEER综合总结分期的患者DSS率存在统计学显著差异(P<0.001)。整个研究队列中癌症死亡的年度风险曲线显示出陡峭的下降趋势,在诊断后2.5年有一个轻微的峰值,随后逐渐下降。远处转移患者的死亡风险曲线更高,下降趋势更明显。CS在整个研究人群中呈上升趋势,在远处转移患者中趋势最为明显。
FTC患者诊断后的预后随时间呈分期依赖性改善。在远处转移患者中观察到最显著的改善。值得注意的是,动态生存估计,如死亡风险和条件生存分析,比传统生存分析为FTC幸存者提供了更精确的生存预测。