Xu Jun, Yao Qixian, Wu Zhongliang, Dou Wenhuan, Liu Yujing
Department of Rehabilitation, The People's Hospital of Suzhou New District, Suzhou, 215008, Jiangsu, China.
Department of Surgery, Community Health Service Center of Suzhou Science & Technology Town, Suzhou, 215008, Jiangsu, China.
Sci Rep. 2024 Dec 30;14(1):32113. doi: 10.1038/s41598-024-83893-4.
This study aimed to determine whether lobectomy is appropriate for the long-term prognosis of 1-4-cm-sized differential thyroid cancer (DTC). This retrospective study included 2,178 patients with 1-4-cm DTC treated via thyroid lobectomy (LT) or total or near-total thyroidectomy (TT) and who were followed up for at least 3 years. The primary endpoint was a structural incomplete response, which was confirmed via imaging with or without a positive histological or cytological examination. Subgroup analysis was performed according to tumor size. LT was performed in 1,535 patients (70.48%), and TT was conducted in the remaining 643 (29.55%) patients. During an average follow-up period of 48.08 months, the recurrence rate was 7.2% in the LT group and 5.3% in the TT group, which was not significantly different (p = 0.108). There were no significant differences in disease-free survival between both groups (hazard ratio, 1.394; 95% confidence interval, 0.9761-1.990; p = 0.089). In the subgroup analysis, the recurrence rates in the LT group were higher than those in the TT group for both the 2-3-cm (13.6% vs. 2.6%, p < 0.01) and 3-4-cm categories (20.6% vs. 4.8%, p < 0.01). For 1-2-cm DTC, surgeons can choose LT or TT owing to their similar recurrence rate, whereas for 2-4-cm DTC, TT is preferred.
本研究旨在确定肺叶切除术是否适用于直径1 - 4厘米的分化型甲状腺癌（DTC）的长期预后。这项回顾性研究纳入了2178例接受甲状腺叶切除术（LT）或甲状腺全切除术或近全切除术（TT）治疗且随访至少3年的1 - 4厘米DTC患者。主要终点是结构上的不完全缓解，通过影像学检查并结合或不结合阳性组织学或细胞学检查来确认。根据肿瘤大小进行亚组分析。1535例患者（70.48%）接受了LT，其余643例（29.55%）患者接受了TT。在平均48.08个月的随访期内，LT组的复发率为7.2%，TT组为5.3%，差异无统计学意义（p = 0.108）。两组间无病生存率无显著差异（风险比，1.394；95%置信区间，0.9761 - 1.990；p = 0.089）。在亚组分析中，对于2 - 3厘米（13.6%对2.6%，p < 0.01）和3 - 4厘米类别（20.6%对4.8%，p < 0.01），LT组的复发率均高于TT组。对于1 - 2厘米的DTC，由于复发率相似，外科医生可选择LT或TT，而对于2 - 4厘米的DTC，首选TT。
