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定期颈部超声检查对低危和中危甲状腺乳头状癌患者甲状腺全切除术后监测中的局部区域疾病控制的影响:一项倾向评分匹配研究。

Impact of periodic neck ultrasonography on locoregional disease control in surveillance after total thyroidectomy for patients with low- and intermediate-risk papillary thyroid carcinoma: a propensity score-matched study.

机构信息

Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.

Department of Clinical Research Education, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan.

出版信息

Endocr J. 2024 Dec 2;71(12):1135-1143. doi: 10.1507/endocrj.EJ24-0194. Epub 2024 Oct 1.

Abstract

This study aimed to evaluate the impact of periodic neck ultrasonography (US) on postoperative surveillance for locoregional disease control of patients with low- and intermediate-risk papillary thyroid carcinoma (PTC) who underwent total thyroidectomy. This retrospective cohort study included patients with PTC who underwent total thyroidectomy and central neck dissection at our institution between January, 2000 and December, 2016. The patients were divided into two groups: the physical examination (PE) group (follow-up by PE without periodic US) and the US group (follow-up by PE with periodic US). Serum thyroglobulin levels were measured periodically in both groups. Propensity score matching was used to rigorously balance the significant variables and assess the 10-year postoperative outcomes between the groups. Of the 189 patients, 150 were included after matching (75 in each group). There were no significant differences between the two groups in terms of background characteristics. The median follow-up period was 127.9 months. There was no significant difference in locoregional relapse-free survival between the PE and US groups (97.0 vs. 98.7%, p = 0.541). The overall survival was 96.7% and 98.7% in the PE and US groups, respectively, with no significant difference (p = 0.364). This study demonstrated that the addition of periodic US to PE for postoperative surveillance of patients with low- and intermediate-risk PTC who underwent total thyroidectomy did not significantly affect locoregional control.

摘要

本研究旨在评估周期性颈部超声(US)对接受全甲状腺切除术的低危和中危甲状腺乳头状癌(PTC)患者局部区域疾病控制术后监测的影响。这是一项回顾性队列研究,纳入了 2000 年 1 月至 2016 年 12 月期间在我院接受全甲状腺切除术和中央颈部清扫术的 PTC 患者。将患者分为体检(PE)组(仅接受 PE 随访,不进行周期性 US)和 US 组(PE 随访+周期性 US)。两组均定期测量血清甲状腺球蛋白水平。采用倾向评分匹配严格平衡两组间的显著变量,并评估两组术后 10 年的结局。在 189 例患者中,匹配后有 150 例患者被纳入研究(每组 75 例)。两组患者的背景特征无显著差异。中位随访时间为 127.9 个月。PE 组和 US 组的局部区域无复发生存率无显著差异(97.0% vs. 98.7%,p=0.541)。PE 组和 US 组的总生存率分别为 96.7%和 98.7%,差异无统计学意义(p=0.364)。本研究表明,在接受全甲状腺切除术的低危和中危 PTC 患者的术后监测中,将周期性 US 与 PE 联合使用并未显著影响局部区域控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49b0/11778352/2ad4ca12b62d/71_EJ24-0194_1.jpg

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