Hamdy Omar, Awny Shadi, Sous Mohamed H, Abdelfattah Mohamed A, Eladl Ahmed E, Elalfy Amr F
Surgical Oncology Department, Oncology Center, Mansoura University, Mansoura, 35516, Egypt.
Faculty of Medicine, Mansoura University, Mansoura, Egypt.
BMC Endocr Disord. 2025 May 7;25(1):123. doi: 10.1186/s12902-025-01877-5.
Insular thyroid carcinoma is a rare subtype of thyroid cancer that constitutes an intermediate entity between differentiated (papillary & follicular) and undifferentiated (anaplastic) thyroid cancer.
This is a retrospective study that included all the patients with insular carcinoma of the thyroid gland who underwent surgical treatment in our department from January 2009 to December 2023. The epidemiological, clinical, and oncological data of the included patients were analyzed.
A total of 1690 patients with thyroid cancer were screened. Twenty-four patients were included in the final analysis. The median time to recurrence (95% CI) was 24 months while the Restricted Mean Survival Time (RMST) at time point 24 months (95% CI) was 16.95. The median time to distant metastasis is 60 months while RMST at time point 24 months was 17.1. The median time to death was 55 months. There was a statistically significant difference in the RMST at 24 months for overall survival (OS) as regards older age, presence of comorbidity, multifocality, and lack of adjuvant RAI, but not sex. Male sex and lack of adjuvant RAI therapy were statistically significant independent predictors of the time to locoregional recurrence. There was no statistically significant difference in the time to distant metastasis as regards all the variables.
From our results, we can conclude that male sex, multifocality, and lack of RAI affect survival in patients with insular thyroid carcinoma. Adequate surgical resection of the thyroid gland and draining lymph nodes in addition to radioactive iodine remains the mainstay of treatment.
岛状甲状腺癌是甲状腺癌的一种罕见亚型，是分化型（乳头状和滤泡状）与未分化型（间变性）甲状腺癌之间的中间类型。
这是一项回顾性研究，纳入了2009年1月至2023年12月在我科接受手术治疗的所有岛状甲状腺癌患者。对纳入患者的流行病学、临床和肿瘤学数据进行了分析。
共筛查了1690例甲状腺癌患者。最终分析纳入24例患者。复发的中位时间（95%CI）为24个月，而24个月时间点的受限平均生存时间（RMST）（95%CI）为16.95。远处转移的中位时间为60个月，24个月时间点的RMST为17.1。死亡的中位时间为55个月。在总体生存（OS）方面，年龄较大、存在合并症、多灶性和缺乏辅助放射性碘治疗在24个月时的RMST存在统计学显著差异，但性别无差异。男性和缺乏辅助放射性碘治疗是局部区域复发时间的统计学显著独立预测因素。在所有变量方面，远处转移时间无统计学显著差异。
从我们的结果可以得出结论，男性、多灶性和缺乏放射性碘影响岛状甲状腺癌患者的生存。除放射性碘外，充分手术切除甲状腺及引流淋巴结仍是主要治疗方法。
