Kim Min-Su, Kang Yung Jee, Ahn Soon-Hyun, Cho Sun-Wook, Park Young-Joo, Kim Su-Jin, Lee Kyu-Eun, Chung Eun-Jae
Department of Otorhinolaryngology-Head and Neck Surgery CHA Bundang Medical Center, CHA University School of Medicine Seongnam Republic of Korea.
Department of Otorhinolaryngology-Head and Neck Surgery Seoul National University Hospital, Seoul National University College of Medicine Seoul Republic of Korea.
Laryngoscope Investig Otolaryngol. 2025 Aug 7;10(4):e70230. doi: 10.1002/lio2.70230. eCollection 2025 Aug.
Research on detected distant metastasis or anaplastic transformation in recurrent/persistent differentiated thyroid cancer is limited. We analyzed the clinical factors associated with detected distant metastasis or anaplastic transformation following reoperation for differentiated thyroid cancer.
This retrospective review included 336 patients who underwent reoperation for differentiated thyroid cancer with detection of distant metastasis or anaplastic transformation following reoperation. The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated.
Distant metastasis was detected in 45 patients (45/336, 13.4%) after reoperation. The risk of distant metastasis was higher for patients of male sex (adjusted HR: 2.373; 95% CI: 1.133-4.973), age ≥ 55 (adjusted HR: 4.991; 95% CI: 2.451-10.165), initial T3-4 stage (adjusted HR: 2.347; 95% CI: 1.035-5.321), in-field recurrence (adjusted HR: 3.267; 95% CI: 1.489-7.168), and those who had undergone ≥ 3 reoperations (adjusted HR: 3.378; 95% CI: 1.248-9.174). Anaplastic transformation was detected in 7 patients (7/336, 2.1%) after reoperation. The risk of anaplastic transformation was higher for patients with an age ≥ 55 (adjusted HR: 6.811; 95% CI: 1.300-35.676) and those who had undergone ≥ 3 reoperations (adjusted HR: 5.672; 95% CI: 1.139-28.236).
In recurrent/persistent differentiated thyroid cancer, distant metastasis or anaplastic transformation following reoperation is not insignificant. There may be increased risk of distant metastasis or anaplastic transformation with multiple reoperations in patients who are men, aged ≥ 55, or at the initial T3-T4 stage.
关于复发性/持续性分化型甲状腺癌中检测到远处转移或间变转化的研究有限。我们分析了分化型甲状腺癌再次手术后检测到远处转移或间变转化的相关临床因素。
这项回顾性研究纳入了336例因分化型甲状腺癌接受再次手术且术后检测到远处转移或间变转化的患者。估计了风险比（HRs）和95%置信区间（CIs）。
再次手术后45例患者（45/336，13.4%）检测到远处转移。男性患者远处转移风险更高（调整后HR：2.373；95%CI：1.133 - 4.973）、年龄≥55岁（调整后HR：4.991；95%CI：2.451 - 10.165）、初始T3 - 4期（调整后HR：2.347；95%CI：1.035 - 5.321）、野内复发（调整后HR：3.267；95%CI：1.489 - 7.168）以及接受≥3次再次手术的患者（调整后HR：3.378；95%CI：1.248 - 9.174）。再次手术后7例患者（7/336，2.1%）检测到间变转化。年龄≥55岁的患者（调整后HR：6.811；95%CI：1.300 - 35.676）以及接受≥3次再次手术患者（调整后HR：
