Survival and death causes in differentiated thyroid carcinoma
Survival and death causes in differentiated thyroid carcinoma
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DOI：
10.1210/jc.2005-1322
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发表时间：
2006-01-01
影响因子：
5.8
通讯作者：
Smit, JW
中科院分区：
文献类型：
--
作者：
Eustatia-Rutten, CFA;Corssmit, EPM;Smit, JW
背景：分化型甲状腺癌（DTC）的生存研究可能存在偏倚，因为这些研究是在异质性人群中进行的。此外，DTC的具体死亡原因在文献中没有很好的记录。目的：我们研究的目的是调查DTC患者同质队列的生存率和具体死亡原因。患者：患者包括366例连续DTC患者，他们都根据相同的初始治疗和随访方案进行治疗。方法：单因素考克斯回归分析DTC相关死亡的预后因素，然后进行逐步多因素考克斯回归分析。标准化死亡率（SMR）计算使用正常死亡率为整个Dutch population.Results：在后续的8.3 +/- 4.6年，82例（22.4%）死亡。在多变量Cox回归分析中，肿瘤分期T4、远处转移和高龄与DTC相关死亡的相对风险增加相关。整个组的SMR为2.32。这可以通过T4期、远处转移或高龄患者的SMR增加来解释。80例患者可证实死亡原因：52例死于DTC，28例死于其他原因。T1- 3 M0期患者中10例死于甲状腺癌。结论：T4、M1期或高龄患者甲状腺癌相关死亡的相对危险度和SMR显著增加。虽然T1- 3 M0患者的死亡风险没有增加，但DTC对所有患者类别的死亡率均有显著影响。
Background: Survival studies in differentiated thyroid carcinoma (DTC) may be biased because they have been performed in heterogeneous populations. In addition, specific death causes in DTC have not been documented well in the literature.Aims: The aim of our study was to investigate survival and specific death causes in a homogeneous cohort of DTC patients.Patients: Patients included 366 consecutive patients with DTC who had all been treated according to the same protocol for initial therapy and follow-up.Methods: Prognostic factors for DTC-related death were analyzed by univariate Cox regression analysis, followed by stepwise multivariate Cox regression analysis. Standardized mortality rates (SMR) were calculated using normal mortality rates for the entire Dutch population.Results: During follow-up of 8.3 +/- 4.6 yr, 82 patients (22.4%) died. At multivariate Cox-regression analysis, tumor stage T4, distant metastases, and advanced age were associated with an increased relative risk for DTC-related death. SMR for the entire group was 2.32. This could be explained by increased SMR in patients with stage T4, distant metastases, or advanced age. Death causes could be verified in 80 patients: 52 died of DTC, 28 due to other causes. Ten of the 20 patients with stage T1-3M0 died from thyroid carcinoma.Conclusion: Relative risk for thyroid cancer-related death and SMR are significantly increased in patients with stage T4 and M1 or advanced age. Although death risk is not increased in T1-3M0 patients, DTC contributed significantly to mortality in all patient categories.