Long-term results of surgery for papillary thyroid carcinoma with local recurrence
Long-term results of surgery for papillary thyroid carcinoma with local recurrence
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DOI：
10.1007/s00595-012-0353-z
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发表时间：
2013-08-01
期刊：
影响因子：
2.5
通讯作者：
Kiuchi, Tetsuya
中科院分区：
文献类型：
--
作者：
Uchida, Hiroki;Imai, Tsuneo;Kiuchi, Tetsuya
局部复发性甲状腺乳头状癌的手术治疗仍存在争议，因为与初次手术相比，手术的发病率更高，而且疗效不明确。本研究分析了手术治疗复发性疾病的疗效和安全性。回顾性队列分析了1979-2009年在同一医院接受局部复发性甲状腺乳头状癌手术治疗的86例患者。所有患者在5年、10年和20年的病因特异性生存率分别为86% （95% CI 77- 95%）、74% （95% CI 62- 87%）和36% （95% CI 18- 54%）。一项单因素分析发现，性别、再手术年龄在45岁以下和肉眼无法治愈的复发手术影响特异性病因生存率。后两个特征在多变量分析中仍然显著。永久性复发性神经麻痹和甲状旁腺功能减退分别发生4例（4.7%）和5例（5.8%）。手术治疗局部复发性甲状腺乳头状癌是有效的，前提是手术安全且发病率低。因此，局部复发性甲状腺乳头状癌的重复手术治疗是值得的。
Surgical treatment of local recurrent papillary thyroid carcinoma is still controversial because of the increased morbidity in comparison to primary surgery, and the unclear efficacy. This study analyzed the efficacy and safety of surgery for recurrent disease.A retrospective cohort analysis of 86 patients who underwent surgery for local recurrent papillary thyroid carcinoma at a single institution during the period 1979-2009.The cause-specific survival rates of all patients at 5, 10, and 20 years were 86 % (95 % CI 77-95 %), 74 % (95 % CI 62-87 %), and 36 % (95 % CI 18-54 %), respectively. A univariate analysis found that gender, age > 45 years at reoperation and macroscopic non-curative surgery for recurrence affected the cause-specific survival rates. The latter two features remained significant in a multivariate analysis. Permanent recurrent nerve paralysis and hypoparathyroidism developed in 4 (4.7 %) and 5 (5.8 %) patients, respectively.Surgery for local recurrent papillary thyroid carcinoma could be effective when macroscopic curative dissection was possible, and that the procedure was safe and was associated with minimal morbidity. Therefore, repeat surgery for local recurrent papillary thyroid carcinoma is worthwhile.