Prognostic implications of microscopic involvement of surgical resection margin in patients with differentiated papillary thyroid cancer after high-dose radioactive iodine ablation
Prognostic implications of microscopic involvement of surgical resection margin in patients with differentiated papillary thyroid cancer after high-dose radioactive iodine ablation
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DOI：
10.1007/s12149-012-0574-7
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发表时间：
2012-05-01
影响因子：
2.6
通讯作者：
Lee, Jaetae
中科院分区：
文献类型：
--
作者：
Hong, Chae Moon;Ahn, Byeong-Cheol;Lee, Jaetae
旨在评估接受甲状腺全切除术后高剂量放射性碘消融 (HDRIA) 的分化型乳头状甲状腺癌 (PTC) 患者手术切缘的微观癌性受累与复发之间的关系。连续 197 名 PTC 患者（184 名女性；平均年龄 44.9 岁）接受甲状腺全切除术，无肉眼残留肿瘤，随后进行 HDRIA 进行了回顾性审查。评估切除边缘受累情况并通过临床病理学评估疾病复发。 HDRIA后12个月内检测到的复发定义为早期复发，12个月后检测到的定义为晚期复发。平均随访时间为85.9+/-16.6个月。 12 名患者 (6.1%) 存在手术切缘的显微镜下癌变[切缘 (+) 组]，185 名患者的手术切缘呈阴性[切缘 (-) 组]。切缘(+)组中有3名患者(25.0%)和切缘(-)组中有11名患者(5.9%)出现早期复发。与边缘 (-) 组相比，边缘 (+) 组早期复发率较高，无病发生率较低（分别为 25.0 vs. 5.9%，< 0.01；66.7 vs. 81.1%，< 0.01）；然而，两组之间的晚期复发率没有差异（= 1.00）。排除早期复发后，切缘（+）组和切缘（-）组之间的无病生存率无显着差异（=0.78）。在大剂量放射性碘消融后，与无显微镜下癌性手术切缘受累的患者相比，有显微镜下癌性手术切缘受累的PTC患者早期复发率较高，而晚期复发率无差异。
To evaluate the relationship between microscopic cancerous involvement of surgical margin and recurrence in patients with differentiated papillary thyroid cancer (PTC) who underwent total thyroidectomy followed by high-dose radioactive iodine ablation (HDRIA).Consecutive 197 PTC patients (184 women; mean age 44.9 years) who underwent total thyroidectomy without gross residual tumor followed by HDRIA were retrospectively reviewed. Resection margin involvement was evaluated and recurrence of the disease was assessed with clinicopathologically. Recurrence detected within 12 months after HDRIA were defined as early recurrence, detected after 12 months were defined as late recurrence.The mean follow-up was 85.9 +/- A 16.6 months. Twelve patients (6.1%) had microscopic cancerous involvement of surgical margin [margin (+) group], and 185 patients had negative surgical resection margins [margin (-) group]. Three patients (25.0%) in the margin (+) group and 11 patients (5.9%) in the margin (-) group had early recurrence. Margin (+) group showed higher incidence of early recurrence and lower incidence of disease free compared to margin (-) group (25.0 vs. 5.9%, < 0.01; 66.7 vs. 81.1%, < 0.01, respectively); however, there was no difference in incidence of late recurrence between the two groups ( = 1.00). There were no significant differences in the disease-free survival between the margin (+) and margin (-) groups after exclusion of early recurrence ( = 0.78).After high-dose radioactive iodine ablation, PTC patients with microscopic cancerous surgical margin involvement had a higher incidence of early recurrence and no different late recurrence rate compared to patients without microscopic cancerous surgical margin involvement.