低复发风险的甲状腺乳头状癌的多灶性：患病率、预测指标、预后意义和初始手术治疗。

IF 1.8 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion Pub Date : 2025-05-01 DOI:10.1016/j.endien.2025.501545

Luis García Pascual , Carlos Puig-Jové , Andreu Simó-Servat , Lluís García-González

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引用次数: 0

摘要

背景与目的：多灶性对甲状腺乳头状癌患者预后的影响与选择甲状腺切除术或全甲状腺切除术的初始手术治疗相关。本研究的目的是确定在我们的环境中多灶性的患病率、其预测指标以及与低复发风险的甲状腺乳头状癌相关的持久性、复发率和死亡率，以便推断最合适的初始手术治疗。患者和方法：85例甲状腺全切除术的回顾性观察性横断面研究。结果：发病率：单灶性癌：68.2%；多病灶的:31.8%。多灶性的预测指标：多结节超声表现（OR:17.069, 95% CI:2.989-97.454）和非偶然发现（OR:7.569, 95% CI:2.363-24.242）。66.6%的多灶病例双侧受累，超声表现均为双侧多结节。结论：考虑到所有病例均行甲状腺全切除术，但多灶性病例放疗频率更高，这是我国首次对复发风险较低的乳头状癌中多灶性的患病率进行估计，且预后良好，与单灶性病例相比无差异。在超声表现为单侧或单侧多结节结节的病例中，半甲状腺切除术与全甲状腺切除术预后相似，但双侧甲状腺多结节病例则不然。

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Multifocality of papillary thyroid carcinoma with low risk of recurrence: Prevalence, predictive markers, prognostic significance and initial surgical treatment

Background and objective

The impact of multifocality on the prognosis of patients with papillary thyroid cancer is relevant when considering the choice of initial surgical treatment by hemithyroidectomy or total thyroidectomy. The aim of the study is to determine the prevalence of multifocality in our setting, its predictive markers and the rates of persistence, recurrence and mortality associated with papillary thyroid cancer with a low risk of recurrence in order to infer the most appropriate initial surgical treatment.

Patients and method

Retrospective observational cross-sectional study of 85 total thyroidectomies.

Results

Prevalences: unifocal carcinoma: 68.2%; multifocal: 31.8%. Predictive markers of multifocality: multinodular ultrasound pattern (OR:17.069, 95% CI:2.989−97.454) and non-incidental finding (OR:7.569, 95% CI:2.363−24.242). In 66.6% of multifocal cases there was bilateral involvement, all of them had a bilateral multinodular ultrasound pattern. Multifocal cases received postoperative radioiodine more frequently (p < 0.001). During the follow-up of 95.5 ± 32.2 months there was one case of persistence and one of recurrence, both in the multifocal group (p:ns), at 12 and 71 months of follow-up. There was no mortality.

Conclusions

This is the first study in our country to estimate the prevalence of multifocality in papillary carcinoma with a low risk of recurrence and to show an excellent prognosis, with no differences compared to unifocal cases, considering that all cases have been treated with total thyroidectomy, but multifocal cases with radioiodine more frequently. Hemithyroidectomy could offer a similar prognosis to total thyroidectomy in cases with an ultrasound pattern of a single or unilateral multinodular nodule, but not in cases of bilateral multinodular thyroid.

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来源期刊

Endocrinologia Diabetes Y Nutricion Multiple-

CiteScore

2.10

自引率

10.50%

发文量

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.