DIFFERENTIATED CARCINOMA OF THE THYROID WITH EXTRATHYROIDAL EXTENSION
DIFFERENTIATED CARCINOMA OF THE THYROID WITH EXTRATHYROIDAL EXTENSION
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DOI：
10.1016/s0002-9610(99)80331-6
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发表时间：
1995-11-01
影响因子：
3
通讯作者：
SHAH, JP
中科院分区：
文献类型：
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作者：
ANDERSEN, PE;KINSELLA, J;SHAH, JP
背景：我们分析了分化型甲状腺癌伴甲状腺外展（ETE）患者的经验，以探讨复发模式并确定预测失败的因素。患者与方法：回顾1930 ~ 1985年1012例手术患者的资料。共有79例（8%）患者发生ETE，中位随访时间为10年。结果：与没有ETE的患者相比，有ETE的患者更容易治疗失败并死于疾病（分别为77%对34%和71%对13%；P < 0.0001），局部、区域和远程失败在有ETE的患者中比没有ETE的患者更为突出(分别为48%对9%，41%对16%，37%对11%；P < 0.0001)非乳头状组织学、远处转移、年龄bbb45岁、肿瘤大小>4cm和不完全切除对te患者的生存有不利影响（P小于或等于0.05），年龄分层后，老年患者的生存不受肿瘤大小或不完全切除的影响，而年轻患者的肿瘤大小或远处转移的存在对生存没有不利影响。年龄小于45岁的切缘阴性患者的生存率与未患ETE的患者相似（P = 0.46）。结论：老年患者的生存不受不完全切除的影响，而年轻患者的生存受不完全切除的影响，远处转移的存在不影响年轻患者的生存。我们的研究结果表明，在45岁以下的患者中，当原发肿瘤被完全切除时，ETE的存在不会对生存产生不利影响。
BACKGROUND: We have analyzed our experience with differentiated thyroid cancer patients with extrathyroidal extension (ETE) to investigate patterns of recurrence and define factors that predict failure.PATIENTS AND METHODS: The records of 1,012 patients treated surgically from 1930 to 1985 were reviewed. A total of 79 patients (8%) had ETE, The median length of follow-up was 10 years.RESULTS: Patients with ETE were more likely to fail treatment and to die of their disease than were patients without ETE (77% versus 34% and 71% versus 13%, respectively; P < 0.0001), Local, regional, and distant failures were more prominent among patients with ETE than among those without ETE (48% versus 9%, 41% versus 16%, and 37% versus 11% respectively; P < 0.0001)Survival of patients with ETE was adversely affected by nonpapillary histology, distant metastasis, age > 45, tumor size > 4 cm, and incomplete excision (P less than or equal to 0.05), After stratification for age, survival in older patients was not affected by tumor size or incomplete excision, while in younger patients tumor size or the presence of distant metastasis did not adversely affect survival. Patients younger than 45 with negative margins had similar survival to patients without ETE (P = 0.46).CONCLUSIONS: Patients with ETE are move likely to die of their disease and to fail at all sites, Survival in older patients was not affected by incomplete excision while it was in younger patients, The presence of distant metastasis did not affect survival in younger patients. Our results suggest that among patients under 45, the presence of ETE does not adversely impact upon survival when the primary tumor is completely resected.