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部分甲状腺切除术与偶然的转移性淋巴结.

Ehab Alameer1,2, Alana Eagan2, Daniel W Scholfield2

  • 1Department of Surgery, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia.

JAMA otolaryngology-- head & neck surgery
|November 16, 2023
PubMed
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对于分化良好的甲状腺癌,完成甲状腺切除术可能不必要,对于部分甲状腺切除术后偶然转移的淋巴结患者. 观察显示高无复发生存率,这表明仔细选择患者是关键.

科学领域:

  • 内分泌学 在内分泌学.
  • 手术瘤学手术瘤学
  • 病理学 病理学 病理学

背景情况:

  • 在部分甲状腺切除术后有偶发转移性淋巴结的患者中,完成甲状腺切除术的必要性仍然不确定.
  • 这项研究涉及在部分甲状腺切除术后被诊断患有偶然转移性淋巴结的患者的结果.

研究的目的:

  • 为了研究部分甲状腺切除术后偶发转移性淋巴结患者的结果.
  • 评估在没有立即完成甲状腺切除术的情况下观察到的患者的无复发生存期.

主要方法:

  • 从第三级转诊癌症中心对前性维护的甲状腺癌数据库 (1985-2015) 的回顾性审查.
  • 包括74名接受部分甲状腺切除术并没有立即完成甲状腺切除术的患者,以及11名立即完成甲状腺切除术的患者.
  • 分析无复发存活率,疾病特异性存活率和整体存活率.

主要成果:

  • 在74名观察患者中 (平均年龄为39岁,59%为女性),70%是中等风险患者. 随访时间中位数为48.15个月,只有1名患者出现区域性复发.
  • 无复发生存率为97.4%,疾病特异性生存率为100%,整体生存率为96.2%.
  • 接受立即完成甲状腺切除术的患者患有更高的侵袭性瘤特征,如高细胞变异性乳头甲状腺癌和正边缘.

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结论:

  • 完成甲状腺切除术对于某些患有偶发转移性淋巴结 (N1a) 部分甲状腺切除术后局部,分化良好的甲状腺癌的患者来说可能不必.
  • 没有立即完成甲状腺切除术的观察在这个患者群体中似乎是安全有效的.
  • 当考虑观察与完成甲状腺切除术时,仔细选择患者至关重要.