原发性甲状腺恶性肿瘤脊柱转移:44例单中心分析。

IF 2.3 3区 医学 Q2 SURGERY
World Journal of Surgery Pub Date : 2025-02-01 Epub Date: 2024-12-10 DOI:10.1002/wjs.12444
Basir Ahmed, Edmond Jonathan, M J Paul, Krishna Prabhu
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引用次数: 0

摘要

背景:分化型甲状腺癌患者10年生存率超过95%。然而,脊髓转移的存在显著降低了总生存率。在这项研究中,我们回顾了甲状腺恶性肿瘤合并脊柱转移患者的流行病学和预后。方法:回顾性分析2008年至2021年在我院治疗的44例甲状腺恶性肿瘤合并脊柱转移患者,通过分析人口学、临床和影像学资料对预后参数进行评价。结果:发病时的中位年龄为58岁(范围从- 35岁到80岁)。54.5%的患者只有单一层次的参与。胸椎受累发生率最高,其次是过渡区和腰椎。最常见的表现是脊柱和神经根痛,其次是脊髓病。在77.3%的病例中,病理被确定为滤泡型甲状腺乳头状癌。总共81.8%的患者接受了甲状腺全切除术,其中84%接受了碘消融,61.3%接受了局部放疗。18人(40.9%)接受了脊柱转移的手术治疗。手术组术后VAS评分有显著改善(p值为0.000)。总体而言,除术后接受放射治疗的患者外,手术组和非手术组的OS和PFS无显著差异(p值为0.013)。结论:原发性甲状腺恶性肿瘤椎体转移切除术可显著缓解疼痛。术后接受放射治疗的患者比接受转移切除术或放射治疗的患者表现更好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Spinal metastases in primary thyroid malignancies: Single center experience of 44 cases.

Background: Patients with differentiated thyroid carcinoma have a 10 year survival rate of more than 95%. However, the existence of spinal metastases significantly reduces overall survival. In this study, we review the epidemiology and outcomes of patients with thyroid malignancies with spinal metastases.

Method: A retrospective analysis was conducted on 44 patients with thyroid malignancy and spinal metastases treated at our institution from 2008 to 2021, evaluating the outcome parameters by analyzing demographic, clinical and radiological profiles.

Results: The median age upon presentation was 58 years (range - 35 to 80 years). 54.5% had single-level involvement. The thoracic spine exhibited the highest incidence of involvement, followed by the transitional zones and lumbar spine. The most common presenting features were spinal and radicular pain followed by myelopathy. In 77.3% of cases, the pathology was identified as the follicular variant of papillary thyroid carcinoma. A total of 81.8% of patients underwent total thyroidectomy, with 84% receiving iodine ablation and 61.3% undergoing locoregional radiotherapy. Surgical intervention for spinal metastases was performed in 18 individuals (40.9%). There was significant improvement in the postoperative Visual Analog Scale (VAS) score in the operated group (p-value of 0.000). Overall, no significant difference was observed in the OS and PFS between the operated and non-operated groups except for the subset of patients who underwent postoperative radiation therapy (p-value of 0.013).

Conclusion: Vertebral metastasectomy in primary thyroid malignancies is associated with significant pain relief. Patients who receive postoperative radiotherapy perform better than patients who either undergo metastasectomy or radiation therapy.

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来源期刊
World Journal of Surgery
World Journal of Surgery 医学-外科
CiteScore
5.10
自引率
3.80%
发文量
460
审稿时长
3 months
期刊介绍: World Journal of Surgery is the official publication of the International Society of Surgery/Societe Internationale de Chirurgie (iss-sic.com). Under the editorship of Dr. Julie Ann Sosa, World Journal of Surgery provides an in-depth, international forum for the most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. Contributions are reviewed and selected by a group of distinguished surgeons from across the world who make up the Editorial Board.
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