{"title":"延迟手术对分化型甲状腺癌和甲状腺髓样癌的影响。","authors":"Maomi Song","doi":"10.1007/s12020-025-04241-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Delay in surgery and the impact on survival in thyroid cancer is unclear. We sought to investigate the association between time to surgery and survival in patients with differentiated thyroid carcinoma (DTC) or medullary thyroid carcinoma (MTC).</p><p><strong>Methods: </strong>In this retrospective study, we included patients who were diagnosed with DTC(including papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC) and oncocytic thyroid carcinoma (OTC)) or MTC between 2000 and 2021. Data was gathered from the Surveillance, Epidemiology and End Results (SEER) database. And we defined the cutoff period for delayed surgery of DTC was 3 months, while 2 months for MTC. Kaplan-Meier method and log-rank test were used to analyze overall survival (OS) and cancer-specific survival (CSS).</p><p><strong>Results: </strong>181588 patients were included in our study. Of which 165,202 (91.0%) were diagnosed with PTC, 9525 (5.2%) were FTC, 4128 (2.3%) were OTC and 2733 (1.5%) were MTC. Comparison of clinical paraments between delayed and non-delayed patients of the four types of thyroid cancer indicated that delayed surgery may alter the clinical characteristics, leading to tumor progression or increased aggressiveness, especially for lymph node metastasis. Meanwhile, delayed surgery (≥3 months) was associated with decreased survival in PTC and FTC, not for OTC. For MTC, delayed surgery (≥2 months) was associated with poorer OS. Additionally, we analyzed the trends in delayed surgery and found that except for an upward trend in PTC, other pathological types showed no significant fluctuations.</p><p><strong>Conclusions: </strong>Delaying surgery for DTC and MTC should be avoided, as this could lead to tumor progression or more aggressive behavior and poorer prognosis.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":" ","pages":""},"PeriodicalIF":3.0000,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of delayed surgery in differentiated thyroid carcinoma and medullary thyroid carcinoma.\",\"authors\":\"Maomi Song\",\"doi\":\"10.1007/s12020-025-04241-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Delay in surgery and the impact on survival in thyroid cancer is unclear. We sought to investigate the association between time to surgery and survival in patients with differentiated thyroid carcinoma (DTC) or medullary thyroid carcinoma (MTC).</p><p><strong>Methods: </strong>In this retrospective study, we included patients who were diagnosed with DTC(including papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC) and oncocytic thyroid carcinoma (OTC)) or MTC between 2000 and 2021. Data was gathered from the Surveillance, Epidemiology and End Results (SEER) database. And we defined the cutoff period for delayed surgery of DTC was 3 months, while 2 months for MTC. Kaplan-Meier method and log-rank test were used to analyze overall survival (OS) and cancer-specific survival (CSS).</p><p><strong>Results: </strong>181588 patients were included in our study. Of which 165,202 (91.0%) were diagnosed with PTC, 9525 (5.2%) were FTC, 4128 (2.3%) were OTC and 2733 (1.5%) were MTC. Comparison of clinical paraments between delayed and non-delayed patients of the four types of thyroid cancer indicated that delayed surgery may alter the clinical characteristics, leading to tumor progression or increased aggressiveness, especially for lymph node metastasis. Meanwhile, delayed surgery (≥3 months) was associated with decreased survival in PTC and FTC, not for OTC. For MTC, delayed surgery (≥2 months) was associated with poorer OS. Additionally, we analyzed the trends in delayed surgery and found that except for an upward trend in PTC, other pathological types showed no significant fluctuations.</p><p><strong>Conclusions: </strong>Delaying surgery for DTC and MTC should be avoided, as this could lead to tumor progression or more aggressive behavior and poorer prognosis.</p>\",\"PeriodicalId\":49211,\"journal\":{\"name\":\"Endocrine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-04-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Endocrine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12020-025-04241-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12020-025-04241-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
Impact of delayed surgery in differentiated thyroid carcinoma and medullary thyroid carcinoma.
Background: Delay in surgery and the impact on survival in thyroid cancer is unclear. We sought to investigate the association between time to surgery and survival in patients with differentiated thyroid carcinoma (DTC) or medullary thyroid carcinoma (MTC).
Methods: In this retrospective study, we included patients who were diagnosed with DTC(including papillary thyroid carcinoma (PTC), follicular thyroid carcinoma (FTC) and oncocytic thyroid carcinoma (OTC)) or MTC between 2000 and 2021. Data was gathered from the Surveillance, Epidemiology and End Results (SEER) database. And we defined the cutoff period for delayed surgery of DTC was 3 months, while 2 months for MTC. Kaplan-Meier method and log-rank test were used to analyze overall survival (OS) and cancer-specific survival (CSS).
Results: 181588 patients were included in our study. Of which 165,202 (91.0%) were diagnosed with PTC, 9525 (5.2%) were FTC, 4128 (2.3%) were OTC and 2733 (1.5%) were MTC. Comparison of clinical paraments between delayed and non-delayed patients of the four types of thyroid cancer indicated that delayed surgery may alter the clinical characteristics, leading to tumor progression or increased aggressiveness, especially for lymph node metastasis. Meanwhile, delayed surgery (≥3 months) was associated with decreased survival in PTC and FTC, not for OTC. For MTC, delayed surgery (≥2 months) was associated with poorer OS. Additionally, we analyzed the trends in delayed surgery and found that except for an upward trend in PTC, other pathological types showed no significant fluctuations.
Conclusions: Delaying surgery for DTC and MTC should be avoided, as this could lead to tumor progression or more aggressive behavior and poorer prognosis.
期刊介绍：
Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology.
Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted.
Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
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