针对持续性或复发性分化甲状腺癌的多次淋巴结解剖后的长期结果
Martin Jose Barrio1, Nikita Pozdeyev2, Robert C McIntyre1
1Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12631 E 17th Ave., C-313 Mail Stop, Aurora, CO, 80045, United States.
American journal of surgery
|November 3, 2024
概括
重复的淋巴结解剖是复发性差异化甲状腺癌 (DTC) 的关键. 虽然有效,但每次手术的成功率都会下降,并发症风险会增加,特别是在中央部剖析期间.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 内分泌学 在内分泌学.
背景情况:
- 局域性复发性/持久性差异化甲状腺癌 (DTC) 通常需要重复的淋巴结剖析.
- 关于多次手术对DTC复发的安全性和长期疗效的数据有限.
研究的目的:
- 评估重复淋巴结解剖的安全性和有效性,用于局部区域的复发性/持久性DTC.
- 评估多次手术对治疗反应和并发症率的影响.
主要方法:
- 在1998年至2022年间接受了宫淋巴结解剖的患者的回顾性分析.
- 数据收集包括人口统计,最初的甲状腺手术细节,随后的淋巴结剖析,随访和治疗反应.
主要成果:
- 随着连续的重复手术,优异反应率下降:一次手术后35.7%,两次手术后20.3%,三次手术后12%,四次重复手术后0%.
- 优秀反应的累积率为41.7%.
- 永久性缺甲状腺症或喉神经复发性损伤的总体风险为5.1%,在接受重复手术中心部剖析 (CNDx) 的患者中,与没有先前CNDx (2.5%) 的患者相比,患者的发病率更高 (8.7%).
结论:
- 手术是复发性/持久性DTC的主要治疗方法,但随着手术的增加,疗效会下降.
- 永久性并发症的风险很低,但在重复的中央部剖析 (CNDx) 时会增加.
相关概念视频
01:27Hyperthyroidism II: Pathophysiology
28
Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH...
28
01:24Graves Disease II: Pathophysiology
26
Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor,...
26