Sato N, Oyamatsu M, Koyama Y, Emura I, Tamiya Y, Hatakeyama K
Department of Surgery, Niigata University School of Medicine, Japan.
J Surg Oncol. 1998 Nov;69(3):151-5. doi: 10.1002/(sici)1096-9098(199811)69:3<151::aid-jso6>3.0.co;2-v.
The importance of nodal involvement as a prognostic factor in differentiated carcinoma of the thyroid gland remains controversial. We therefore attempted to confirm the prognostic factors in differentiated thyroid carcinoma, with special reference to nodal status.
A total of 139 patients with differentiated thyroid cancer followed for 2-27 years, with a median follow-up of 7 years were studied. All patients underwent surgical resection, either subtotal, total, or lobectomy, with modified radical neck dissection. Survival was calculated using the Kaplan-Meier method.
Ten (7%) patients have died from thyroid cancer. Adverse prognostic factors included age >45 years (P=0.0120), the presence of distant metastases (P=0.0006), and TNM stage (P=0.0002). The number of lymph nodes dissected ranged from 6 to 92, with an average of 26. Lymph node metastases were found in 102 (73%) patients. There was no difference in survival according to the level of nodal disease by the TNM classification. Furthermore, the number of cervical lymph nodes involved had no effect on the survival.
Our results suggest that the presence of histologically confirmed lymph node metastases is not an important prognostic factor in patients with differentiated thyroid carcinoma.
在甲状腺分化型癌中，淋巴结受累作为预后因素的重要性仍存在争议。因此，我们试图确定甲状腺分化型癌的预后因素，特别关注淋巴结状态。
共研究了139例甲状腺分化型癌患者，随访时间为2至27年，中位随访时间为7年。所有患者均接受了手术切除，包括次全切除、全切除或叶切除，并进行改良根治性颈清扫术。采用Kaplan-Meier法计算生存率。
10例（7%）患者死于甲状腺癌。不良预后因素包括年龄>45岁（P=0.0120）、存在远处转移（P=0.0006）和TNM分期（P=0.0002）。清扫的淋巴结数量为6至92个，平均为26个。102例（73%）患者发现有淋巴结转移。根据TNM分类，按淋巴结疾病水平划分的生存率无差异。此外，颈部受累淋巴结的数量对生存率没有影响。
我们的结果表明，组织学证实有淋巴结转移并非甲状腺分化型癌患者的重要预后因素。
