Long-term outcomes and prognostic factors in papillary thyroid microcarcinoma patients with distant metastases
Long-term outcomes and prognostic factors in papillary thyroid microcarcinoma patients with distant metastases
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甲状腺微小乳头状癌远处转移患者的长期结局和预后因素
DOI：
10.1007/s12020-021-02906-8
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发表时间：
2021-10-26
期刊：
影响因子：
3.7
通讯作者：
Qiu, Zhong-Ling
中科院分区：
文献类型：
--
作者：
Weng, Huai-Yu;Yan, Ting;Qiu, Zhong-Ling
目的甲状腺微小乳头状癌 (PTMC) 的远处转移极为罕见，其长期结果和独立预后因素仍不清楚。本研究旨在探讨接受手术和放射性碘（131I）治疗的远处转移（DM）PTMC患者的临床病理特征，评估其长期结局和预后因素。方法回顾性分析2008年1月至2019年12月在我院接受131I治疗的13,441例甲状腺癌患者（其中1697例PTMC）的病历。具有足够临床随访数据的远处转移 PTMC 患者纳入本队列研究。采用Kaplan-Meier法分析总生存期（OS）和无进展生存期（PFS），并采用Cox比例风险评估预后因素。结果33例合并DM的PTMC患者纳入本研究。中位随访时间为 75 个月（范围：5-151 个月）。 5年和10年OS率分别为96.97和81.41%，5年和10年PFS率分别为90.46和69.68%。多变量分析显示，男性 (P= 0.005)、放射性碘难治性 PTMC (P= 0.033) 和有症状的 DM (P= 0.022) 与合并 DM 的 PTMC 患者较差的 10 年 PFS 显着相关。本研究中未发现与不良10年OS相关的独立预测因素。结论 PTMC患者的预后在发生DM后变得更差。男性、放射性碘难治性 PTMC 和有症状的 DM 被确定为与 PFS 相关的独立因素。
PurposesDistant metastasis from papillary thyroid microcarcinoma (PTMC) is extremely rare and the long-term outcomes and independent prognostic factors remain unclear. The present study aimed to investigate clinicopathological characteristics and evaluate the long-term outcomes and prognostic factors of PTMC patients with distant metastases (DM) who underwent surgery and radioactive iodine (131I) treatment.MethodsWe retrospectively reviewed the medical records of 13,441 patients with thyroid cancer (including 1697 cases with PTMC) who underwent131I treatment at our institution between January 2008 and December 2019. PTMC patients with distant metastases with sufficient clinical follow-up data were enrolled in this cohort study. The overall survival (OS) and progression-free survival (PFS) were analyzed by the Kaplan–Meier method and the prognostic factors were assessed by Cox proportional hazards.ResultsThirty-three PTMC patients with DM were enrolled in this study. The median follow-up was 75 months (range: 5–151 months). The 5-year and 10-year OS rates were 96.97 and 81.41%, respectively, and the 5-year and 10-year PFS rates were 90.46 and 69.68%, respectively. Multivariate analysis showed that male sex (P= 0.005), radioactive iodine refractory PTMC (P= 0.033), and symptomatic DM (P= 0.022) were significantly associated with worse 10-year PFS in PTMC patients with DM. No independent predictor related to poor 10-year OS was found in the present study.ConclusionsThe prognosis of PTMC patients becomes worse after the development of DM. Male sex, radioactive iodine refractory PTMC, and symptomatic DM were identified as independent factors associated with PFS.