乳头甲状腺癌主动监测的生存益处:基于SEER数据库的倾向性得分匹配分析
Jinzhe Bi1, Peng-Fei Lyu2, Yu Wang2
1Department of General Surgery, The First Affiliated Hospital of Hainan Medical University, Haikou, China.
Frontiers in oncology
|June 26, 2023
概括
主动监测 (AS) 是可行的皮皮质甲状腺微癌 (PTMC). 手术可能有利于患有超过2.0厘米的大型乳头甲状腺癌 (PTC) 瘤的患者,但需要进一步的试验.
科学领域:
- 在瘤学瘤学.
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
背景情况:
- 甲状腺 papillary microcarcinoma (PTMC) 的过度治疗是一个令人担忧的问题.
- 建议对PTMC进行主动监测 (AS),但标准和风险尚不清楚.
- 研究手术对较大的乳头甲状腺癌 (PTC) 的生存益处,以评估AS的可行性.
研究的目的:
- 为了评估手术对较大的PTC瘤的生存益处.
- 确定扩展 PTC 的 AS 标准的可行性.
- 分析瘤大小对PTC预后的影响.
主要方法:
- 从SEER数据库中对PTC患者 (2000-2019) 的回顾性分析.
- 倾向性得分匹配 (PSM) 用于比较手术和非手术组.
- 卡普兰-梅尔和考克斯的比例危险模型来评估预后.
主要成果:
- 在PTC中,瘤大小对于疾病特异性存活率 (DSS) 来说至关重要.
- 在手术和非手术组之间没有显著的DSS差异,瘤≤1.0cm.
- 观察到PTC瘤>2.0cm的生存风险增加;化疗,放射性和多焦点性对DSS产生负面影响.
结论:
- 积极监测 (AS) 是T1N0M0 PTC.的一个可行的策略.
- 瘤大小存在潜在的门,超出这个门后,手术可能会改善存活率.
- 需要进一步进行大规模的前性试验,以确认发现并完善AS指导方针.
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