甲状腺未分化癌88例治疗及预后分析

目的探讨甲状腺未分化癌患者的生存状况及预后因素。方法回顾性分析天津市肿瘤医院2003年1月—2016年5月收治的88例甲状腺未分化癌患者的临床及随访资料,采用Kaplan-Meier法及Cox多因素回归分析预后因素。结果 88例甲状腺未分化癌患者的中位生存时间为3.5月;6月生存率30.7%,1年生存率为22.7%,2年生存率为11.4%。单因素分析显示,肿物最大径、年龄、远处转移、淋巴结转移、分期、白细胞数、放疗、化疗、甲状腺结节、不同手术方式、综合治疗是影响甲状腺未分化癌患者预后的因素。多因素分析显示,影响预后的独立因素为年龄、分期、白细胞数、综合治疗。结论甲状腺未分化癌预后极差,对于ⅣA、ⅣB期患者手术切除联合术后放化疗的综合治疗方案可延长其生存期,即使丧失手术机会的患者仍能从放疗和(或)化疗中获益。

Treatment and Prognosis of Anaplastic Thyroid Carcinoma: A Clinical Study of 88 Cases

Objective To evaluate the survival and prognostic factors of patients with anaplastic thyroid carcinoma (ATC). Methods We retrospectively analyzed the clinical and follow-up data of 88 ATC patients treated in our hospital from January 2003 to May 2016. Potential prognostic factors were analyzed by Kaplan-Meier curve and Cox multivariate analyses. Results The median survival time of 88 patients was 3.5 months. The 6-month, 1-year and 2-year survival rates were 30.7%, 22.7% and 11.4%, respectively. Univariate analysis showed the factors influencing the prognosis of ATC patients were tumor size, distant metastases, stage, age, lymph node metastasis, leukocytosis, radiotherapy, chemotherapy, pre-existing goiter, local resection and comprehensive therapy. Multivariate analysis indicated that age, stage, leukocytosis and comprehensive therapy were independently associated with the prognosis. Conclusion ATC patients have poor prognosis. Combined surgery and chemoradiotherapy could improve overall survival of stage IVA and IVB ATC patients. Inoperable patients could still benefit from chemoradiotherapy.