Limited Thyroidectomy Achieves Equivalent Survival to Total Thyroidectomy for Early Localized Medullary Thyroid Cancer.
1/5 보강
PICO 자동 추출 (휴리스틱, conf 3/4)
유사 논문P · Population 대상 환자/모집단
398 patients with T1N0/1M0 MTC treated with total thyroidectomy or lobectomy/subtotal thyroidectomy from 2000 to 2019.
I · Intervention 중재 / 시술
total thyroidectomy, while 10
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
The selective use of limited thyroidectomy may be reasonable for low-risk T1N0/1M0 MTC patients. Delayed surgery is associated with worse survival and additional neck dissection showed no benefit for this select group of patients.
[BACKGROUND] The optimal surgical approach for localized T1 medullary thyroid cancer remains unclear.
- 추적기간 8.75 years
APA
Jishu JA, Hussein MH, et al. (2024). Limited Thyroidectomy Achieves Equivalent Survival to Total Thyroidectomy for Early Localized Medullary Thyroid Cancer.. Cancers, 16(23). https://doi.org/10.3390/cancers16234062
MLA
Jishu JA, et al.. "Limited Thyroidectomy Achieves Equivalent Survival to Total Thyroidectomy for Early Localized Medullary Thyroid Cancer.." Cancers, vol. 16, no. 23, 2024.
PMID
39682246 ↗
Abstract 한글 요약
[BACKGROUND] The optimal surgical approach for localized T1 medullary thyroid cancer remains unclear. Total thyroidectomy is standard, but lobectomy and subtotal thyroidectomy may minimize mortality while maintaining oncologic control.
[METHODS] This retrospective analysis utilized the National Cancer Institute's Surveillance, Epidemiology, and End Results registry to identify 2702 MTC patients including 398 patients with T1N0/1M0 MTC treated with total thyroidectomy or lobectomy/subtotal thyroidectomy from 2000 to 2019. Cox regression analyses assessed thyroid cancer-specific and overall mortality.
[RESULTS] The majority (89.7%) underwent total thyroidectomy, while 10.3% had lobectomy/subtotal thyroidectomy. Nodal metastases were present in 29.6%. Over a median follow-up of 8.75 years, no significant difference was observed in cancer-specific mortality (5.7% vs. 8.1%, = 0.47) or overall mortality (13.2% vs. 12.8%, = 0.95). On multivariate analysis, undergoing cancer-directed surgery was associated with significantly improved overall survival (HR 0.18, < 0.001) and cancer-specific survival (HR 0.17, < 0.001) compared to no surgery. However, no significant survival difference was seen between total thyroidectomy and lobectomy/subtotal thyroidectomy for overall mortality (HR 0.77, = 0.60) or cancer-specific mortality (HR 0.44, = 0.23). The extent of surgery also did not impact outcomes within subgroups stratified by age, gender, T stage, or nodal status. Delayed surgery >1 month after diagnosis was associated with worse overall survival ( = 0.012).
[CONCLUSIONS] For localized T1 MTC, lobectomy/subtotal thyroidectomy appears to achieve comparable long-term survival to total thyroidectomy in this population-based analysis. The selective use of limited thyroidectomy may be reasonable for low-risk T1N0/1M0 MTC patients. Delayed surgery is associated with worse survival and additional neck dissection showed no benefit for this select group of patients.
[METHODS] This retrospective analysis utilized the National Cancer Institute's Surveillance, Epidemiology, and End Results registry to identify 2702 MTC patients including 398 patients with T1N0/1M0 MTC treated with total thyroidectomy or lobectomy/subtotal thyroidectomy from 2000 to 2019. Cox regression analyses assessed thyroid cancer-specific and overall mortality.
[RESULTS] The majority (89.7%) underwent total thyroidectomy, while 10.3% had lobectomy/subtotal thyroidectomy. Nodal metastases were present in 29.6%. Over a median follow-up of 8.75 years, no significant difference was observed in cancer-specific mortality (5.7% vs. 8.1%, = 0.47) or overall mortality (13.2% vs. 12.8%, = 0.95). On multivariate analysis, undergoing cancer-directed surgery was associated with significantly improved overall survival (HR 0.18, < 0.001) and cancer-specific survival (HR 0.17, < 0.001) compared to no surgery. However, no significant survival difference was seen between total thyroidectomy and lobectomy/subtotal thyroidectomy for overall mortality (HR 0.77, = 0.60) or cancer-specific mortality (HR 0.44, = 0.23). The extent of surgery also did not impact outcomes within subgroups stratified by age, gender, T stage, or nodal status. Delayed surgery >1 month after diagnosis was associated with worse overall survival ( = 0.012).
[CONCLUSIONS] For localized T1 MTC, lobectomy/subtotal thyroidectomy appears to achieve comparable long-term survival to total thyroidectomy in this population-based analysis. The selective use of limited thyroidectomy may be reasonable for low-risk T1N0/1M0 MTC patients. Delayed surgery is associated with worse survival and additional neck dissection showed no benefit for this select group of patients.
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