甲状腺乳头状癌远处转移的危险因素：与外侧淋巴结转移的关系

IF 1.6 4区医学 Q2 OTORHINOLARYNGOLOGY

Auris Nasus Larynx Pub Date : 2025-02-11 DOI:10.1016/j.anl.2025.01.008

Masataka Nakamura , Nobuya Monden , Tomonori Terada , Nobuhiro Uwa , Yuichiro Shinoda , Junko Fukutake , Hiroshi Kono , Takehito Kishino , Naoki Akisada , Yuji Hayashi , Kenzo Tsuzuki

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引用次数: 0

摘要

目的探讨N1a、N1b甲状腺乳头状癌（PTC）远处转移的特点及淋巴结转移作为远处转移危险因素的意义。方法选取2013年1月至2020年12月在兵库医科大学和2007年1月至2018年12月在国癌症中心接受手术治疗的537例N1a和N1b PTC患者，其中283例（男性79例，女性204例）进行淋巴结转移分析。中位年龄58岁（范围19 ~ 93岁），术后中位观察时间73个月（范围1 ~ 152个月）。ResultsThe远处转移的发生率更高水平II或转移时发现诉多变量分析表明显著增加远处转移率的因素是年龄≥55岁(p = 0.011),肿瘤大小比;4 cm (p = 0.034)， II和V级淋巴结转移（p = 0.034）。结论对于N1b转移患者，特别是II级或V级转移患者，应考虑甲状腺全切除术合并侧颈清扫术作为术后放射性碘治疗的首选。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Risk factors for distant metastasis in papillary thyroid carcinoma: Association with lateral lymph node metastasis

Objective

This study aimed to clarify the characteristics of distant metastasis in patients with N1a and N1b papillary thyroid carcinoma (PTC) and the significance of lateral lymph node metastasis as a risk factor for distant metastasis.

Methods

Of the 537 patients with N1a and N1b PTC who underwent surgical treatment at Hyogo Medical University from January 2013 to December 2020 and Shikoku Cancer Center from January 2007 to December 2018, 283 (79 men and 204 women) with lymph node metastasis were analyzed in this study. The median age was 58 (range, 19–93) years, and the median observation period was 73 (range, 1–152) months after surgery.

Results

The incidence rate of distant metastasis was higher when metastases were detected at levels II or V. Multivariate analysis revealed that the factors that significantly increased the distant metastasis rate were age ≥ 55 years (p = 0.011), tumor size > 4 cm (p = 0.034), and lymph node metastasis at levels II and V (p = 0.034).

Conclusions

For patients with N1b metastasis, specifically at levels II or V, total thyroidectomy with lateral neck dissection should be considered the primary choice for postoperative radioactive iodine therapy.

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来源期刊

Auris Nasus Larynx 医学-耳鼻喉科学

CiteScore

3.40

自引率

5.90%

发文量

169

审稿时长

30 days

期刊介绍： The international journal Auris Nasus Larynx provides the opportunity for rapid, carefully reviewed publications concerning the fundamental and clinical aspects of otorhinolaryngology and related fields. This includes otology, neurotology, bronchoesophagology, laryngology, rhinology, allergology, head and neck medicine and oncologic surgery, maxillofacial and plastic surgery, audiology, speech science. Original papers, short communications and original case reports can be submitted. Reviews on recent developments are invited regularly and Letters to the Editor commenting on papers or any aspect of Auris Nasus Larynx are welcomed. Founded in 1973 and previously published by the Society for Promotion of International Otorhinolaryngology, the journal is now the official English-language journal of the Oto-Rhino-Laryngological Society of Japan, Inc. The aim of its new international Editorial Board is to make Auris Nasus Larynx an international forum for high quality research and clinical sciences.