Impact of extent thyroidectomy and radioactive iodine ablation for disease free survival in the intermediate-risk patients with lateral neck lymph node metastasis: a retrospective and tentative real-world approach.

IF 2.5 3区 医学 Q3 ONCOLOGY
Kiyomi Horiuchi, Yuki Yamanashi, Tomoyoshi Nakai, Juro Yanagida, Yusaku Yoshida, Yoko Omi, Takahiro Okamoto
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引用次数: 0

Abstract

Background: It is controversial whether or not total thyroidectomy followed by radioactive iodine ablation (RAI-a) (30 mCi = 1.1 GBq) is mandatory in intermediate-risk patients with lateral neck lymph node metastasis (cN1b).

Methods: This retrospective observational study enrolled PTC patients classified preoperatively as the intermediate-risk with cN1b from January 2010 to December 2017 according to the guidelines for thyroid tumors of the Japanese Association of Endocrine Surgeons (JAES) since 2009. We analyzed recurrence-free survival (RFS) rates estimated by the Kaplan-Meier method in the patients classified into three groups: 1) total thyroidectomy (TTx) followed by lateral neck lymph node dissection (LLND) with RAI-a, 2) TTx + LLND without RAI-a, 3) hemithyroidectomy + LLND. In addition, propensity score analysis adjusted by clinical parameters was performed.

Results: Two hundred eighty-eight patients with intermediate-risk PTC were identified. Among them, 87 patients with cN1b were analyzed. Five-year RFS rates in 1), 2), and 3) groups were 85.0%, 100%, and 90.9%, respectively. The analysis of 1) and 2) groups by propensity score matching revealed 5-yr RFS rates of 84.1% and 100%, respectively (p < 0.0432).

Conclusions: There was no evidence to support the use of 30 mCi (1.1GBq) radioactive iodine postoperatively to prevent recurrence in intermediate-risk PTC patients with cN1b.

甲状腺切除术和放射性碘消融对中危颈部外侧淋巴结转移患者无病生存的影响:回顾性和试试性现实方法
背景:对于中危颈侧淋巴结转移(cN1b)患者,全甲状腺切除术后放射性碘消融(RAI-a) (30mci = 1.1 GBq)是否必需存在争议。方法:本回顾性观察研究纳入2010年1月至2017年12月根据日本内分泌外科医师协会(JAES) 2009年起甲状腺肿瘤指南术前分类为cN1b中危的PTC患者。我们分析了Kaplan-Meier法估计的患者的无复发生存率(RFS),将患者分为三组:1)甲状腺全切除术(TTx)合并侧颈淋巴结清扫(LLND)合并ra -a, 2) TTx + LLND不合并ra -a, 3)甲状腺切除术+ LLND。此外,进行经临床参数调整的倾向评分分析。结果:确定了288例中危性PTC患者。其中分析了87例cN1b患者。1)、2)和3)组5年RFS分别为85.0%、100%和90.9%。倾向评分匹配分析1)组和2)组的5年RFS分别为84.1%和100% (p)。结论:没有证据支持在cN1b的中危PTC患者术后使用30 mCi (1.1GBq)放射性碘预防复发。
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来源期刊
CiteScore
4.70
自引率
15.60%
发文量
362
审稿时长
3 months
期刊介绍: World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.
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