未行选择性中央区淋巴结清扫的cN0甲状腺乳头状癌的远期结果

发布时间：2018-03-09 05:13

本文选题：甲状腺乳头状癌　切入点：cN　出处：《中国医学科学院学报》2017年03期 　论文类型：期刊论文

【摘要】：目的总结c N0甲状腺乳头状癌(PTC)未行选择性中央区淋巴结清扫的转归。方法回顾性分析中国医学科学院肿瘤医院2000年1月至2005年12月未行选择性中央区淋巴结清扫的180例颈部阴性的PTC患者的临床资料,包括性别、年龄、手术方式、组织类型、原发灶大小及是否被膜外侵犯等。结果中位随访时间90个月。180例PTC患者中,1例死于非肿瘤因素;共计16例发生复发,其中残叶复发7例,局部复发2例,中央区淋巴结复发6例,侧颈区淋巴结复发8例,肺转移1例。10年总体生存率为99.4%,疾病特异性生存率为100%,无复发生存率为87.9%,中央区淋巴结累积复发率为7.8%,颈侧区淋巴结累积复发率为7.0%。甲状腺被膜外侵犯是中央区淋巴结复发的独立危险因素,男性(P=0.010)和甲状腺被膜外侵犯(P=0.028)是颈侧区淋巴结复发的独立危险因素。结论未行选择性中央区淋巴结清扫的c N0 PTC患者,经过10年随访,预后良好,男性和甲状腺被膜外侵犯是颈侧区淋巴结复发的独立危险因素。
[Abstract]:Objective to summarize the outcome of non-selective central lymph node dissection in c N0 papillary thyroid carcinoma. Methods the results of selective central lymph node dissection from January 2000 to December 2005 in Cancer Hospital of Chinese Academy of Medical Sciences were retrospectively analyzed. Clinical data of 180 cervical negative PTC patients, Results the median follow-up time was 90 months. 1 of 180 PTC patients died of non-tumor factors, and a total of 16 patients recurred. There were 7 cases of residual lobe recurrence, 2 cases of local recurrence, 6 cases of central lymph node recurrence, 8 cases of lateral cervical lymph node recurrence. The overall survival rate was 99.4%, the disease-specific survival rate was 100%, the non-recurrence survival rate was 87.9%, the cumulative recurrence rate of the central lymph nodes was 7.8%, the cumulative recurrence rate of the cervical lymph nodes was 7.0%. The extramembranous invasion of the thyroid gland was the central area. Independent risk factors for lymph node recurrence, Male patients with Pn0. 010) and thyroid extramembranous invasion (P0. 028) are independent risk factors for lymph node recurrence in the lateral cervical region. Conclusion the prognosis of c N0 PTC patients without selective central lymph node dissection is good after 10 years follow-up. Male and extramedullary thyroid invasion are independent risk factors for lymph node recurrence in the cervical lateral region.
【作者单位】：云南省红河州第三人民医院甲状腺乳腺外科;国家癌症中心中国医学科学院北京协和医学院肿瘤医院头颈外科;
【分类号】：R736.1

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