根据分化型甲状腺癌的肿瘤大小,甲状腺外大面积扩展到带状肌的临床意义:系统综述和荟萃分析。

IF 2.9 3区 医学 Q1 OTORHINOLARYNGOLOGY
Ho-Ryun Won, Hyo-One Son, Sumin Yi, Ji Won Kim, Jae Won Chang, Bon Seok Koo
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引用次数: 0

摘要

目的:分化型甲状腺癌(DTC)患者出现甲状腺外扩展(ETE)是预测其预后的一个重要指标。因此,DTC的肿瘤分期分为广泛ETE和仅影响带状肌的粗大ETE(粗大带状肌侵犯;gSMI)。然而,关于 gSMI 与预后的关系,尤其是与肿瘤大小的关系,目前还没有足够的证据:方法:在 MEDLINE、Embase、Cochrane Library 和 KoreaMed 中检索相关文献。所有过程均按照 PRISMA 指南进行,并由两名独立审稿人进行。考虑到研究的多样性,采用随机效应模型进行了荟萃分析。非随机研究评估工具 RoBANS 2.0 版用于评估所选研究的质量。收集了分析 ETE 程度与预后关系的观察性研究的临床数据,并进行了荟萃分析:本研究共纳入了 18 项观察性研究。对每个结果都进行了分组分析。gSMI患者的复发率(几率比[OR]:2.498)、疾病特异性死亡率(风险比[RR]:2.984)、总死亡率(RR:1.361)和淋巴结(LN)转移率(OR:5.355)均显著高于无ETE患者。结论:gSMI 对预后有负面影响;但当肿瘤较小时,这种相关性会减弱。因此,在治疗过程中应采取更加谨慎的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical significance of gross extrathyroidal extension to only the strap muscle according to tumor size in differentiated thyroid cancer: a systematic review and metaanalysis.

Objective: The presence of extrathyroidal extension (ETE) in differentiated thyroid cancer (DTC) patients is an important predictor of their prognosis. Therefore, the tumor stage of DTC is divided into extensive ETE and gross ETE only affecting the strap muscle (Gross strap muscles invasion; gSMI). However, insufficient evidence exists regarding the association of gSMI with the prognosis, especially in relation to tumor size.

Methods: Related literature was searched in MEDLINE, Embase, Cochrane Library and KoreaMed. All processes were performed in accordance with PRISMA guidelines, and the process was conducted by two independent reviewers. The meta-analysis was performed using a random-effect model considering the diversity of studies. RoBANS version 2.0, an evaluation tool for non-randomized studies, was used to evaluate the quality of the selected research. Clinical data from observational studies that analyzed the relationship between the degree of ETE and prognosis were collected, and a meta-analysis was performed.

Results: Eighteen observational studies were included in this study. A subgroup analysis was performed for each outcome. The recurrence rate (odds ratio [OR]: 2.498), disease-specific mortality (risk ratio [RR]: 2.984), overall mortality (RR: 1.361) and lymph node (LN) metastasis (OR: 5.355) were significantly higher in patients with gSMI than in those with no ETE. However, in an analysis limited to tumors 4 cm or smaller, no significant difference in prognostic outcomes was seen, except for LN metastasis.

Conclusion: gSMI has a negative impact on the prognosis; however, this correlation diminishes when the tumor size is small. Thus, a more cautious approach is warranted during the treatment process.

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来源期刊
CiteScore
4.90
自引率
6.70%
发文量
49
审稿时长
6-12 weeks
期刊介绍: Clinical and Experimental Otorhinolaryngology (Clin Exp Otorhinolaryngol, CEO) is an international peer-reviewed journal on recent developments in diagnosis and treatment of otorhinolaryngology-head and neck surgery and dedicated to the advancement of patient care in ear, nose, throat, head, and neck disorders. This journal publishes original articles relating to both clinical and basic researches, reviews, and clinical trials, encompassing the whole topics of otorhinolaryngology-head and neck surgery. CEO was first issued in 2008 and this journal is published in English four times (the last day of February, May, August, and November) per year by the Korean Society of Otorhinolaryngology-Head and Neck Surgery. The Journal aims at publishing evidence-based, scientifically written articles from different disciplines of otorhinolaryngology field. The readership contains clinical/basic research into current practice in otorhinolaryngology, audiology, speech pathology, head and neck oncology, plastic and reconstructive surgery. The readers are otolaryngologists, head and neck surgeons and oncologists, audiologists, and speech pathologists.
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