老年分化型甲状腺癌患者术后长期生存状况及其影响因素分析

Analysis of long-term survival of elderly patients with differentiated thyroid cancer after surgery and its influencing factors

目的观察老年分化型甲状腺癌(DTC)患者术后长期生存状况,并分析可能影响患者术后长期生存的因素。方法分析2017年1月至2020年6月商丘市第一人民医院甲乳外科术后.完成5年随访的80例老年DTC患者临床资料,统计患者生存情况及生存时间,比较不同基本情况患者病死率的差异,Cox回归分析老年DTC术后5年长期生存状况的危险因素。结果80例老年DTC患者平均随访时间为(4.53±0.41)年,随访期间病死18例,病死率为22.50%(18/80),生存率为77.50%(62/80);Cox回归分析结果显示,组织学类型(滤泡状甲状腺癌)、手术方式(单侧腺叶切除术)、未经颈部淋巴结清扫、碘治疗剂量低均是老年DTC患者术后5年长期生存状况的影响因素(OR=5.888、5.795、6.753、4.923,P=0.004、0.004、0.002、0.003)。结论老年DTC患者5年长期生存状况可能受组织学类型、手术方式、颈部淋巴结清扫、碘治疗剂量的影响,临床应重视上述影响,针对可能的生存风险因素应针对性给出合适的干预方案,可能对改善患者远期生存状况有积极意义。

Objeetive To examine the long term survival of elderly patients with differentiated thyroid cancer(DTC)after surgery,and to analyze its influencing factors.Methods Clinical data of 80 elderly DTC patients from our department who had completed a 5-year post-surgery follow up between January 2017 and June 2020 were analyzed.The survival characteristics and survival time of patients were analyzed.The difference in mortality was compared in patients with different general conditions.Influencing factors for long-term survival in elderly DTC patients 5 years after surgery were analyzed by using Cox regression.Results Of 80 elderly DTC patients,the average survival time was 4.53±0.41 years,18 cases died during the follow-up period,the mortality was 22.50%(18/80),and the survival rate was 77.50%(62/80).Cox regression analysis showed that histological type(ollicular thyroid cancer),surgical method(unilateral gland resection),no cervical lymph node dissection and low therapeutic doses of iodine were influencing factors for the long term survival of elderly DTC patients 5 years after surgery(OR=5.888,5.795,6.753 and 4.923,P=0.004,0.004,0.002 and 0.003).Conclusions The 5-year long-term survival of elderly DTC patients may be affected by the histological type,surgical method,cervical lymph node dissection and therapeutic doses of iodine.Clinical management with an emphasis on these factors and with targeted risk mitigation intervention plans may offer a positive impact on the long-term survival for patients.