低风险乳头甲状腺癌的积极监测的长期结果:进展模式和瘤化
Iwao Sugitani1,2, Ryuta Nagaoka1, Marie Saitou1
1Department of Endocrine Surgery, Nippon Medical School, Tokyo, Japan.
World journal of surgery
|November 26, 2024
概括
低风险乳头甲状腺癌的积极监测是长期安全的. 在老年患者和化瘤患者中,进展是罕见的,这表明随访可能会结束.
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:
- 积极监测 (AS) 是低风险的乳头甲状腺癌 (PTC) 的有效策略.
- 关于AS进展模式的长期证据有限,需要终身监测.
- 高龄是PTC进展的一个已知的有利因素.
研究的目的:
- 调查AS下低风险PTC患者的长期进展模式.
- 探索瘤化在AS进展中的作用.
- 评估选择患者中断长期随访的可行性.
主要方法:
- 对650名低风险PTC患者的回顾性分析,与AS一起管理.
- 进展定义为瘤扩大 (≥3毫米) 或淋巴结转移.
- 分析瘤化,年龄和观察时间.
主要成果:
- 12.3%的患者 (80/650) 在中位数为8年的随访期间 (45.2%>10年) 呈现出进展.
- 在15岁或80岁后进展很少;36/40次手术发生在10年内.
- 没有观察到与边缘化瘤的进展;进展往往自发停止.
结论:
- 在低风险PTC中AS期间的进展在老年患者和化瘤患者中是罕见的.
- 对于特定的患者群体来说,可能有可能停止定期监测.
- 瘤扩大自发停止是AS期间常见的现象.
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