ORIGINAL ARTICLE

Correlates of Recurrence-Free Survival in Papillary Thyroid Carcinoma: A Cohort Study in an Iranian Population
Papiller Tiroid Karsinomunda Nükssüz Sağkalım ile İlişkili Faktörler: İran Popülasyonunda Bir Kohort Çalışması
Received Date : 27 Feb 2021
Accepted Date : 13 Sep 2021
Available Online : 27 Sep 2021
Doi: 10.25179/tjem.2021-82672 - Makale Dili: EN
Turk J Endocrinol Metab. 2021;25:351-360
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Papillary thyroid carcinoma (PTC) is considered differentiated and has a good prognosis; however, the patient's survival differs from clinicopathological risk factors. This study is meant to assess factors predicting recurrence-free survival. Material and Methods: In this longitudinal study, we examined a cohort of 208 patients with PTC from 1977 to 2020. Patients who underwent total thyroidectomy entered the study. Thyroidectomy was considered the primary event, while the endpoint of the study was recurrence-free survival. A multivariate and univariate Cox regression test was used to identify independent risk factors in recurrence-free survival. Results: The 5-year recurrence- free survival was 90.5% [95% confidence interval (CI): 84.7-96.46]. Multiple regression models displayed that gender [p=0.01 hazard ratio (HR): 2.21, 95% CI 1.20-4.05] and tumor size (p=0.02 HR: 1.93, 95% CI 1.10-3.38) were the most significant factors influencing recurrence-free survival. The median recurrence- free survival among our patients was 12 years. According to the Kaplan-Meier tests, 5 and 10-year recurrencefree survival was 90.5% (95% CI: 84.7-96.46) and 51.7% (95% CI: 41.26-62.26), respectively. The median recurrence-free survival of the tumor was 24 years in tumors <1 cm and ten years in tumors in the range of 1-3.99 cm and ≥4 cm (p=0.02). Conclusion: The 5-year recurrence-free survival was 90.5% longer in women and those with tumors less than 1 cm. Tumor size and gender may affect the risk of recurrence/persistent disease.
ÖZET
Amaç: Papiller tiroid karsinomu (PTK) diferansiye kabul edilir ve iyi bir prognoza sahiptir; ancak hastanın sağkalımı klinikopatolojik risk faktörlerine göre farklılaşmaktadır. Bu çalışma, nükssüz sağkalımı öngördüren faktörleri değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Bu uzunlamasına çalışmada, 1977-2020 tarihleri arasında PTK’li 208 hastadan oluşan bir kohort çalışmasını inceledik. Çalışmaya total tiroidektomi yapılan hastalar dâhil edildi. Tiroidektomi primer olay olarak kabul edildi, çalışmanın sonlanım noktası ise nükssüz sağkalımdı. Nükssüz sağkalımda bağımsız risk faktörlerini belirlemek için çok değişkenli ve tek değişkenli Cox regresyon testi kullanıldı. Bulgular: Beş yıllık nükssüz sağkalım %90,5 idi [%95 güven aralığı (GA): 84,7-96,46]. Çoklu regresyon modelleri, cinsiyetin [p=0,01 tehlike oranı (hazard ratio “HR”): 2,21, %95 GA 1,20-4,05] ve tümör boyutunun (p=0,02 HR: 1,93, %95 GA 1,10-3,38) sağkalımı etkileyen en önemli faktörler olduğunu gösterdi. Hastalarımız arasında medyan nükssüz sağkalım 12 yıl idi. Kaplan-Meier testlerine göre 5 ve 10 yıllık nükssüz sağkalımlar sırasıyla %90,5 (%95 GA: 84,7-96,46) ve %51,7 (%95 GA: 41,26-62,26) idi. Medyan nükssüz sağkalım, boyutu <1 cm olan tümörlerde 24 yıl, boyutu 1-3,99 cm aralığında ve ≥4 cm olan tümörlerde 10 yıl idi (p=0,02). Sonuç: Beş yıllık nükssüz sağkalım kadınlarda ve 1 cm’den küçük tümörü olanlarda %90,5 daha uzun bulunmuştur. Tümör boyutu ve cinsiyet, nüks/persistan hastalık riskini etkileyebilir.
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