第二原发性甲状腺乳头状癌:来自竞争风险分析和rait后的见解。

IF 2.4 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Mingjun Wang, Wenjie Chen, Peiheng Li, Yanping Gong
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引用次数: 0

摘要

背景:癌症生存率的提高突出了第二原发性恶性肿瘤(SPMs),甲状腺是癌症幸存者中发生SPMs的最常见器官之一。第二原发性乳头状甲状腺癌(2-PTC)是主要类型,但仍知之甚少。本研究旨在描述2-PTC的临床病理特征和生存结局,并评估术后放射性碘治疗(post-RAIT)在降低中危2-PTC患者死亡风险方面的疗效。方法:使用SEER-17数据库(2004-2019),我们将6399例2- ptc患者作为队列1,分析其特征和结局,将1743例作为队列2,检查rait后的影响。竞争风险回归模型应用于评估既往原发性恶性肿瘤(PPMs)和其他原因的死亡风险。采用500个bootstrap样本的倾向得分匹配和稳定逆概率处理加权进行稳健性分析。结果:2-PTC患者的主要人口统计学特征包括年龄较大、女性和白人。乳腺癌(25.5%)、前列腺癌(9.8%)和皮肤癌(6.7%)是最常见的PPMs。6.3%的患者出现不良PPMs。尽管与PPMs和其他原因相比,2- ptc的累积死亡率较低,但在队列2中,即使在年龄≥55岁、临床IV期疾病或不利PPMs的患者中,rait后也没有显著降低死亡风险。敏感性分析证实了这些发现。结论:2-PTC患者的生存预后普遍良好,rait后对中危病例的死亡率无显著影响,需要重新评估其使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Second Primary Papillary Thyroid Carcinoma: Insights From Competing Risk Analysis and Post-RAIT.

Background: Improved cancer survival rates have highlighted second primary malignancies (SPMs), with the thyroid gland being one of the most common organs developing SPMs in cancer survivors. Second primary papillary thyroid carcinoma (2-PTC) is the predominant type, yet it remains poorly understood. This study aims to delineate the clinicopathological features and survival outcomes of 2-PTC and assess the efficacy of postoperative radioactive iodine therapy (post-RAIT) in reducing mortality risks in intermediate-risk 2-PTC patients.

Methods: Using the SEER-17 database (2004-2019), we identified 6399 2-PTC patients as Cohort 1 to analyze characteristics and outcomes, and 1743 as Cohort 2 to examine post-RAIT effects. Competing risk regression models were applied to assess mortality risks from prior primary malignancies (PPMs) and other causes. Propensity score matching and stabilized inverse probability treatment weighting with 500 bootstrap samples were used for robust analysis.

Results: Predominant demographic characteristics of 2-PTC patients included older age, female sex, and white ethnicity. Breast (25.5%), prostate (9.8%), and skin cancer (6.7%) were the most common PPMs. Unfavorable PPMs were found in 6.3% of patients. Despite lower cumulative mortality from 2-PTC compared to PPMs and other causes, post-RAIT did not significantly reduce mortality risks in Cohort 2, even among patients aged ≥ 55 years, with clinical stage IV disease, or unfavorable PPMs. Sensitivity analyses confirmed these findings.

Conclusion: The survival prognosis for 2-PTC patients is generally favorable, and post-RAIT does not significantly affect mortality in intermediate-risk cases, indicating a need for reevaluation of its use.

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来源期刊
Clinical Endocrinology
Clinical Endocrinology 医学-内分泌学与代谢
CiteScore
6.40
自引率
3.10%
发文量
192
审稿时长
1 months
期刊介绍: Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.
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