https://scholars.lib.ntu.edu.tw/handle/123456789/496597
標題: | The impact of locoregional recurrences and distant metastases on the survival of patients with papillary thyroid carcinoma | 作者: | Su D.-H. SHU-HUI CHANG TIEN-CHUN CHANG |
公開日期: | 2015 | 出版社: | Blackwell Publishing Ltd | 卷: | 82 | 期: | 2 | 起(迄)頁: | 286-294 | 來源出版物: | Clinical Endocrinology | 摘要: | Objective Some patients with papillary thyroid carcinoma (PTC) would suffer from locoregional recurrences or distant metastases. This study was aimed to elucidate the impacts of locoregional recurrences and distant metastases on these patients' survival. Design Retrospective hospital-based cohort study. Population Data were collected from 1636 subjects with PTC at National Taiwan University Hospital between 1985 and 2007. Measurements Overall and disease-specific survival curves were estimated by the Kaplan-Meier method. Time-independent and time-dependent prognostic factors were included simultaneously in multivariate analyses using Cox models. Results Overall survival (OS) rates at 10- and 20-years were 90% and 76%, respectively. The 10- and 20-year disease-specific survival (DSS) rates were 95% and 90%, respectively. Our multivariate analyses identified that older age, distant metastases (hazard ratio, HR: 6·69, 95% CI: 4·40-10·18), locoregional recurrences (HR: 1·88, 95% CI: 1·22-2·89), lymph node metastases, massive extrathyroid extension, male gender and larger tumour size (>4 cm) were significantly associated with poorer OS. Older age, distant metastases (HR: 15·03, 95% CI: 8·31-27·21), locoregional recurrences (HR: 3·63, 95% CI: 2·03-6·51), massive extrathyroid extension, male gender and larger tumour size (>4 cm) were independently related to worse DSS. The performance of high-dose 131I ablation had a protective effect on OS and DSS. Conclusion The locoregional recurrences had a moderately harmful impact on OS and DSS, but age and distant metastases were the major decisive factors for OS and DSS. High-dose 131I ablation had a protective role. However, lymph node dissection did not alter the prognosis whenever lymph node metastases only influenced OS. ? 2014 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84921598726&doi=10.1111%2fcen.12511&partnerID=40&md5=3e42789682348f975027b11a400468b5 https://scholars.lib.ntu.edu.tw/handle/123456789/496597 |
ISSN: | 0300-0664 | DOI: | 10.1111/cen.12511 | SDG/關鍵字: | iodine 131; radioactive iodine; adult; aging; Article; cancer prognosis; cancer recurrence; cancer survival; cohort analysis; correlation analysis; disease specific survival; distant metastasis; female; human; locoregional recurrence; long term survival; lymph node metastasis; major clinical study; male; overall survival; priority journal; retrospective study; risk factor; sex difference; thyroid carcinoma; thyroidectomy; tumor ablation; tumor invasion; tumor volume; carcinoma; epidemiology; lymph node dissection; metastasis; middle aged; mortality; pathology; statistics and numerical data; survival; Taiwan; Thyroid Neoplasms; tumor recurrence; Adult; Carcinoma; Female; Humans; Iodine Radioisotopes; Lymph Node Excision; Male; Middle Aged; Neoplasm Metastasis; Neoplasm Recurrence, Local; Retrospective Studies; Survival Analysis; Taiwan; Thyroid Neoplasms; Thyroidectomy |
顯示於: | 醫學系 |
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