甲状腺切除术与甲状腺切除术对散发性髓状甲状腺癌:一个中国全国大型队列研究
Xiao Shi1, Cenkai Shen1, Chuqiao Liu1
1Department of Head and Neck Surgery, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
Journal of the National Comprehensive Cancer Network : JNCCN
|February 7, 2025
概括
甲状腺切除术 (HT) 是针对小,单边零星状甲状腺癌 (sMTC) 的全甲状腺切除术 (TT) 的安全替代方案,提供了可比的结果,而不会影响预后.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
- 遗传学 遗传学 是一个
背景情况:
- 状甲状腺癌 (MTC) 是一种罕见的恶性瘤,零星病例 (sMTC) 占70-80%.
- 目前的指导方针建议在可疑的sMTC中进行全甲状腺切除术 (TT),但对较少广泛的手术的证据越来越多.
- 关于对sMTC进行甲状腺切除术 (HT) 的安全性存在有限的数据.
研究的目的:
- 评估甲状腺膜切除术 (HT) 与甲状腺全切除术 (TT) 相比,甲状腺膜切除术 (HT) 的安全性和有效性,用于偶发性髓性甲状腺癌 (sMTC) 患者.
- 评估结果,包括隐藏的双边疾病,复发率,生化反应,结构性无复发生存率 (SRFS) 和整体生存率 (OS).
主要方法:
- 在19个转诊中心对797名MTC患者进行初始治愈手术的回顾性研究.
- 基因测试以确定遗传病例,重点是648名经过遗传确认的sMTC患者.
- 对HT (n=232) 与TT (n=416) 结果进行比较, 230对的倾向性得分匹配.
主要成果:
- 在HT和TT组之间的OS,SRFS或生化反应之间没有显著差异.
- 隐藏的双侧焦点很少见 (2.4%在TT中,0.43%在HT中,瘤≤2厘米).
- 在小型 (≤2厘米) sMTC中,HT显示出与TT相似的结果,即使具有高风险因素.
结论:
- 甲状腺膜切除术 (HT) 是针对小,单侧零星状甲状腺癌 (sMTC) 的全甲状腺切除术 (TT) 的可行的替代方案.
- HT不会影响瘤的结果,并可能减少手术并发症.
- 对于特定的sMTC病例,考虑HT是合理的.
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