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加拿大甲状腺癌调查。

Canadian survey of thyroid cancer.

作者信息

Simpson W J, McKinney S E

出版信息

Can Med Assoc J. 1985 Apr 15;132(8):925-31.

Abstract

We report the results of a multicentre retrospective chart review of 2214 patients with thyroid cancer registered at 13 radiotherapy centres between 1958 and 1978. The data analysed included sex, age at the time of diagnosis, pathological diagnosis, extent of disease before treatment, types of treatment and their complications, and the rates of recurrence and survival up to 24 years after diagnosis. Although papillary cancers were most common, anaplastic and miscellaneous tumours were more frequent than expected, which reflects the type of patients referred by endocrinologists and surgeons to radiotherapy centres. There were marked differences in patterns of referral to the centres. Some patients with papillary and follicular thyroid cancers died of these cancers up to 20 years after diagnosis. The clinical manifestations, treatment and outcome of the rarer types of thyroid malignant tumours were of particular interest. The influence of age at the time of diagnosis on survival rates for patients with papillary or follicular thyroid cancer was highly significant, indicating much more aggressive behaviour of these cancers in older patients, particularly those beyond the age of 60 years. A more detailed analysis of tumour subtypes should provide new information on their natural history and lead to better management.

摘要

我们报告了一项多中心回顾性图表审查的结果,该审查涉及1958年至1978年间在13个放疗中心登记的2214例甲状腺癌患者。分析的数据包括性别、诊断时的年龄、病理诊断、治疗前疾病范围、治疗类型及其并发症,以及诊断后长达24年的复发率和生存率。虽然乳头状癌最为常见,但间变性和其他肿瘤比预期的更频繁,这反映了内分泌科医生和外科医生转诊至放疗中心的患者类型。各中心的转诊模式存在显著差异。一些乳头状和滤泡状甲状腺癌患者在诊断后长达20年死于这些癌症。较罕见类型的甲状腺恶性肿瘤的临床表现、治疗和结果尤其令人关注。诊断时的年龄对乳头状或滤泡状甲状腺癌患者生存率的影响非常显著,表明这些癌症在老年患者,尤其是60岁以上患者中的行为更具侵袭性。对肿瘤亚型进行更详细的分析应能提供有关其自然史的新信息,并带来更好的管理。

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