The Journal of otolaryngology · 2004
Prognostic implications of site of recurrence in patients with recurrent well-differentiated thyroid cancer.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Waseem Zeeshan, Palme Carsten E, Walfish Paul, Freeman Jeremy L
Аннотация
OBJECTIVE: The site of treatment failure in patients with recurrent well-differentiated thyroid carcinoma (WDTC) has implications for both the mode of salvage therapy and disease-specific prognosis. The objective of this study was to evaluate the prognostic significance of the site of failure in patients with recurrent WDTC.
DESIGN: Patients with recurrent thyroid cancer were identified retrospectively from 1963 to 2000.
SETTING: Data were retrieved from the thyroid cancer database at the Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, Toronto (1963-2000).
METHODS: Patients were placed into four different groups according to their site of recurrence: group 1, local recurrence; group 2, regional recurrence; group 3, distant recurrence; and group 4, unspecified recurrence. Patient, tumour, and treatment data were collected and compared. The Kaplan-Meier method was used to calculate survival data, and curves were compared using the log rank test.
MAIN OUTCOME MEASURES: Outcome included alive, no disease; alive with disease; dead, no disease; and dead of disease.
RESULTS: Seventy-three patients (21 male, 52 female; median age 44 years, range 18-84 years) were eligible for inclusion in this study. Relevant data were divided according to group 1, 22 patients; group 2, 24 patients; group 3, 13 patients; and group 4, 14 patients. The groups were comparable in terms of primary tumour and treatment factors. The actuarial disease-specific survival rate after salvage therapy was less significant in patients who developed a distant recurrence versus a local recurrence, a regional recurrence, or an unspecified recurrence (ie, 66% vs 95%, 88%, and 92%, respectively; p = .06).
CONCLUSIONS: Patients with distant recurrences have a poor prognosis, with a significant reduction in the actuarial disease-specific survival rate.
DESIGN: Patients with recurrent thyroid cancer were identified retrospectively from 1963 to 2000.
SETTING: Data were retrieved from the thyroid cancer database at the Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, Toronto (1963-2000).
METHODS: Patients were placed into four different groups according to their site of recurrence: group 1, local recurrence; group 2, regional recurrence; group 3, distant recurrence; and group 4, unspecified recurrence. Patient, tumour, and treatment data were collected and compared. The Kaplan-Meier method was used to calculate survival data, and curves were compared using the log rank test.
MAIN OUTCOME MEASURES: Outcome included alive, no disease; alive with disease; dead, no disease; and dead of disease.
RESULTS: Seventy-three patients (21 male, 52 female; median age 44 years, range 18-84 years) were eligible for inclusion in this study. Relevant data were divided according to group 1, 22 patients; group 2, 24 patients; group 3, 13 patients; and group 4, 14 patients. The groups were comparable in terms of primary tumour and treatment factors. The actuarial disease-specific survival rate after salvage therapy was less significant in patients who developed a distant recurrence versus a local recurrence, a regional recurrence, or an unspecified recurrence (ie, 66% vs 95%, 88%, and 92%, respectively; p = .06).
CONCLUSIONS: Patients with distant recurrences have a poor prognosis, with a significant reduction in the actuarial disease-specific survival rate.