对于T3b差异化甲状腺癌的叶切除术和全甲状腺切除术后的可比生存率:基于人口的研究
Chen Li1, Xiangyi Xiao1, Hongqin Jiang2
1Department of General Surgery, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.
Oral oncology
|February 17, 2026
概括
手术程度对分化甲状腺癌 (DTC) 阶段T3b的存活率的影响很小. 叶切除术提供了与全甲状腺切除术相似的结果,支持T3b DTC患者的个性化治疗方法.
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:
- 当前的2025年美国甲状腺协会指南建议对所有T3b分化甲状腺癌 (DTC) 进行全甲状腺切除术.
- 在T3b DTC中,手术程度的预后意义尚未得到充分确立.
- 这项研究研究了T3b DTC.手术方法与生存之间的关系.
研究的目的:
- 评估外科手术方法 (全甲状腺切除 vs 带切除) 与T3b DTC患者的生存结果之间的关联.
- 为了确定手术程度与其他预后因素相比的相对重要性.
- 评估不同瘤大小和节点状况的生存等价性.
主要方法:
- 来自SEER数据库 (2004-2022) 的6920名T3b DTC患者的分析.
- 使用SHAP值和随机生存森林评估的重要变量.
- 用于生存分析的多变量考克斯回归和细灰模型,考虑整体生存率和疾病特异性生存率.
主要成果:
- 手术方法对结果的预测价值最小,小于年龄,瘤大小和结节状况.
- 乳腺切除术的总生存率与甲状腺切除术的总生存率相当 (调整HR为0.96,95%CI为0.68-1.37).
- 瘤大小和结节状况子组的生存等价值一致;有利风险的患者超过96%的疾病特异性生存率.
结论:
- 手术程度似乎对T3b DTC.生存的影响有限.
- 对精心挑选的T3b DTC患者来说,乳房切除术可能是一个合适的选择.
- 个人化治疗策略,而不是普遍的全甲状腺切除术,是支持T3b DTC.
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