Abstract:
Objective To investigate the operational mode of differentiated thyroid carcinoma(DTC) in different condition and its relationship with prognosis.
Methods Retrospective analysis the clinical data of 325 cases of DTC treated from 1993 to 2000, and according the main factors influencing prognosis, we do stratified analysis using multivariate cox regression model by corrected confounded factors, to evaluate the relationship between surgical operational mode and prognosis of DTC.
Results The factors that influenced the prognosis of DTC included gender, age, recurrence, clinicopathological stage, primary tumor size, and treatment pattern (P< 0.05), but only age, treatment pattern and clinicopathological stage influenced the prognosis of DTC according to Cox multivariate analysis(P<0.05). Stratified by age, hemithyroideetomys with isthmus resections was the best way in the higher age group, and taking total thyroidectomy as reference, it's OR was 0.320. But in the lower age group, there was no significant statistical difference in operational mode. Taking clinicopathological stage as a stratified factor, hemithyroideetomy was a good choice(OR=0.228) in stageⅠ, but in the higer stage, subtotal thyroidectomy seemed better(OR=0.561).
Conclusions Age, operational mode and clinicopathological stage are main factors that influenced the prognosis of DTC. We should select the best surgical operational mode by take the patient's tolerance as consideration, according to age and clinicopathological stage.
Key words:
Differentiated thyroid carcinoma,
Thyroid Neoplasms,
Prognosis
Hong ZHOU, Chen YAO, Yuan-hui LAI, Guang-hui LUO, Yongnian CHEN. Investigation of surgical operational mode for differentiated thyroid cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2010, 04(03): 246-251.