Wagner H E, Birrer A, Lüscher B, Kinser J, Rösler H
Klinik für Viszerale und Transplantationschirurgie, Inselspital Bern.
Helv Chir Acta. 1993 Jun;59(5-6):819-23.
270 patients with papillary thyroid carcinoma were retrospectively analyzed. The mean age at initial diagnosis was 43.5 years. 74% of the patients were females. 15 patients (6%) had residual tumor after initial surgery and 61 patients (24%) showed recurrent disease. The recurrence was discovered clinically, radiologically and by increasing thyroglobulin levels in 72%, 23% and 5% of the patients, respectively. Recurrent disease was located in the tumor bed, locally and metastatic and only metastatic in 61%, 23% and 16% of the patients, respectively. After a mean follow-up of 9.4 years (range 3-20 years) the overall mortality was 13%. 6% of the patients died from tumor, 3% with tumor and 4% without tumor. 46% of patients with residual tumor died from tumor progression, in contrast to 18% of patients with early recurrence (< 5 years) and 6% of patients with late recurrence (> 5 years). We conclude that papillary thyroid carcinoma has a low mortality (6%) even in an endemic area. Patients with residual tumor after initial surgery and patients with early recurrence have an increased cancer mortality.
对270例甲状腺乳头状癌患者进行回顾性分析。初次诊断时的平均年龄为43.5岁。74%的患者为女性。15例患者（6%）在初次手术后有残留肿瘤，61例患者（24%）出现疾病复发。复发分别在72%、23%和5%的患者中通过临床、影像学检查以及甲状腺球蛋白水平升高发现。复发疾病分别位于肿瘤床、局部和转移部位，仅转移的患者分别占61%、23%和16%。平均随访9.4年（范围3 - 20年）后，总死亡率为13%。6%的患者死于肿瘤，3%伴有肿瘤，4%无肿瘤。46%有残留肿瘤的患者死于肿瘤进展，相比之下，早期复发（<5年）的患者为18%，晚期复发（>5年）的患者为6%。我们得出结论，即使在流行地区，甲状腺乳头状癌的死亡率也较低（6%）。初次手术后有残留肿瘤的患者和早期复发的患者癌症死亡率增加。
