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- W4298088223 abstract "Objective: To investigate the clinicopathological characteristics and the survival of re-operated patients for persistent/recurrent papillary thyroid carcinoma (PTC) and risk factors for re-recurrence after the second operation. Method: A retrospective analysis of 69 cases underwent re-operation for persistent/recurrent PTC in Sichuan Cancer Hospital from January 2010 to December 2016 was performed. There were 21 males and 48 females, aged 14-85 (44.8) years old. According to the imaging after initial treatment, they were divided into a recurrence group (42 cases) and a persistent disease/residual group (27 cases). The positive rates of ipsilateral paratracheal lymph node metastases at re-operation were calculated and compared by chi-square test. Patients were divided into different subgroups according to potential risk factors for re-recurrence. Kaplan-Meier (K-M) method was used for survival analysis. Results: The positive rate of ipsilateral paratracheal lymph node metastasis in recurrence group (15/42, 35.7%) was significantly lower than that in the persistent disease/residual group (17/27, 63.0%) (χ2=4.91, P<0.05). The follow-up period after re-operation was 60-104 months, with a median of 66 months, and 8 patients were lost to follow-up. Permanent hypoparathyroidism occurred in 2 cases (2.9%) and permanent recurrent laryngeal nerve palsy in 1 case (1.4%). Twenty patients had structural recurrences and/or distant metastases. The 5-year disease-specific survival rate was 92.8% and the 5-year recurrence-free survival rate was 68.1%. Survival analysis was performed on risk factors such as age≥55 years old, recurrent tumor diameter ≥4 cm, number of positive lymph nodes ≥ 10, and obvious extracapsular invasion (ENE). Among them, age and diameter of recurrent tumor had significant influences on recurrence-free survival rate (χ2 was 6.36, 8.17, respectively, both P values<0.05). There was a statistically significant difference in recurrence-free survival rates between ENE(+) group and ENE(-) group (χ2=5.52, P<0.05). Conclusion: For the re-operated patients due to persistence/ recurrence PTC, attention should be paid to protecting the parathyroid gland and recurrent laryngeal nerve during re-operation. Timely and effective postoperative follow-up for patients aged ≥ 55 years, with recurrent tumor diameter ≥ 4 cm and ENE(+), can significantly improve their prognoses.目的: 探讨持续/复发甲状腺乳头状癌(PTC)再手术患者的临床病理特征与不同再复发风险因素下的生存状况。 方法: 回顾性分析2010年1月至2016年12月,四川省肿瘤医院收治的69例行再次甲状腺手术且两次手术术后病理诊断均为PTC患者的临床资料,其中男性21例,女性48例,年龄14~85岁。根据初治术后影像学状态分为复发组(42例)和疾病持续状态/残留组(简称残留组,27例),计算再手术时同侧气管旁淋巴结转移阳性率,结果采用卡方检验比较。针对不同复发危险因素分组,采用Kaplan-Meier法进行生存分析。 结果: 复发组的同侧气管旁淋巴结转移阳性率(35.7%,15/42)与残留组(63.0%,17/27)比较,差异有统计学意义(χ2=4.91,P<0.05)。再手术术后随访60~104个月,中位随访时间66个月,8例患者失访;发生永久性甲状旁腺功能减退2例(2.9%),永久性喉返神经麻痹1例(1.4%);20例患者出现结构性复发和/或远处转移。5年疾病特异性生存率为92.8%,5年无复发生存率为68.1%。对相关危险因素(年龄≥55岁、复发肿瘤直径≥4 cm、阳性淋巴结数目≥10个、明显包膜外侵犯)进行生存分析,其中年龄、复发肿瘤直径对于无复发生存率差异有统计学意义(χ2值分别为6.36、8.17,P值均<0.05)。对于是否存在淋巴结结外侵犯(extranodal extension,ENE),将ENE(+)组与ENE(-)组无复发生存率进行比较,差异有统计学意义(χ2=5.52,P<0.05)。 结论: 针对持续/复发PTC患者,再手术术中注意保护甲状旁腺及喉返神经,对年龄≥55岁、复发肿瘤直径≥4 cm以及ENE(+)患者及时有效地进行术后随访可以改善其预后。." @default.
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- W4298088223 date "2022-09-07" @default.
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- W4298088223 title "[Clinical features and prognoses of re-operated patients for persistent/recurrent papillary thyroid carcinoma]." @default.
- W4298088223 doi "https://doi.org/10.3760/cma.j.cn115330-20211231-00842" @default.
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