Treatment and prognosis for patients with differentiated thyroid carcinoma bone metastases.
Treatment and prognosis for patients with differentiated thyroid carcinoma bone metastases.
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分化型甲状腺癌骨转移患者的治疗及预后
DOI：
10.21037/tcr.2019.12.43
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发表时间：
2020-03
影响因子：
0.9
通讯作者：
Sun C
中科院分区：
文献类型：
--
作者：
Wang S;Luo J;Zhong Z;Qi X;Liu T;Qin R;Zhao Z;Xi Y;Sun R;Wu Y;Sun C
探讨分化型甲状腺癌（DTC）骨转移（BM）患者的合理治疗方式及预后因素。
回顾性分析1993年11月1日至2016年12月31日在昆明医科大学第三附属医院接受治疗的所有DTC骨转移患者的临床病理特征及随访资料，分析死亡率和生存率。采用Cox比例风险模型进行多因素分析。
60例患者的5年和10年总生存率（OS）分别为51.5%和17.2%。单因素分析显示，45岁以下诊断为骨转移、促甲状腺激素（TSH）水平得到控制以及接受手术或131I治疗的患者预后较好。颈椎转移、除骨外多器官转移以及接受化疗的患者预后较差。性别、病理类型、骨转移病灶数量、骨相关事件（SREs）以及患者是否接受放疗与预后无关。Cox回归分析表明，骨转移诊断时的年龄、接受骨病灶手术以及未接受化疗是DTC骨转移患者预后良好的独立因素。
DTC骨转移患者预后较差。骨转移诊断时年龄小于45岁、接受骨病灶手术以及未接受化疗是DTC骨转移患者预后良好的独立因素。131I联合骨转移病灶手术可能是大多数DTC骨转移患者的最佳治疗模式。
Background To investigate reasonable treatment modalities and prognostic factors for patients with differentiated thyroid carcinoma (DTC) bone metastases (BM). Methods The clinicopathological characteristics and follow-up data for all patients with DTC BM who received treatment in the Third Affiliated Hospital of Kunming Medical University between November 1, 1993 and December 31, 2016 were analyzed retrospectively with respect to mortality and survival rates. Multivariate analysis was performed using the Cox proportional hazard model. Results The 5- and 10-year overall survival (OS) rates were 51.5% and 17.2%, respectively, for all 60 patients. Univariate analysis showed that patients diagnosed with BM at <45 years of age, with controlled thyroid-stimulating hormone (TSH) levels and those undergoing surgery or 131I therapy had better prognoses. Patients with cervical vertebra metastases, multiple organ metastases other than bone, and those receiving chemotherapy had worse prognoses. Gender, pathological type, number of BM lesions, skeletal-related events (SREs) and whether or not the patient received radiotherapy were not related to prognosis. Cox regression analysis showed that age at diagnosis of BM, undergoing surgery for bone lesions, and not receiving chemotherapy were independent factors of favorable prognosis for patients with DTC BM. Conclusions Patients with DTC BM have poor prognoses. Age at diagnosis with BM <45 years old, undergoing surgery for bone lesions, and not receiving chemotherapy were independent factors of favorable prognosis for patients with DTC BM. 131I combined with surgery for bone metastatic lesions may be the best treatment model for most patients with DTC BM disease.
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影响因子：
5.8
作者：
Durante, C.;Haddy, N.;Schlumberger, M.
通讯作者：
Schlumberger, M.
DOI：
10.1007/s002590000420
发表时间：
2001-02-01
期刊：
EUROPEAN JOURNAL OF NUCLEAR MEDICINE
影响因子：
--
作者：
Petrich, T;Widjaja, A;Knapp, WH
通讯作者：
Knapp, WH
影响因子：
3
作者：
TOKUHASHI, Y;MATSUZAKI, H;OHSAKA, S
通讯作者：
OHSAKA, S
影响因子：
2.6
作者：
PROYE, CAG;DROMER, DHR;SULMAN, C
通讯作者：
SULMAN, C
影响因子：
5.8
作者：
Qiu, Zhong-Ling;Song, Hong-Jun;Luo, Quan-Yong
通讯作者：
Luo, Quan-Yong