ABSTRACT
Objective:To investigate the risk factors related to extrathyroidal extension (ETE) of differentiated thyroid carcinoma (DTC) and the specific effects on the prognosis.Methods:The clinical data of 592 patients with newly diagnosed DTC admitted to our hospital from Jun. 2015 to Jun. 2016 were retrospectively analyzed. The data including the maximum tumor diameter and lymph node metastasis were collected, and the survival data were followed up. Chi-square test and Logistic regression were used to analyze the risk factors associated with ETE. Kaplan-Meier method and Cox proportional risk model were used to analyze the effect of ETE on disease-free survival.Results:There were 100 ETE of 592 DTC patients (16.9%) . Univariate analysis showed that the risk factors for ETE were the largest tumor diameter ≥2 cm, multiple lesions, and lymph node metastasis in the lateral cervical region ( P<0.01) . The follow-up time was 29 to 64 months, and the median follow-up time was 60 months. The 3-year and 5-year DFS rates of patients with DTC and ETE were 86.9% and 83.2% respectively, which were significantly lower than those of patients without ETE ( P<0.001) . Univariate analysis showed that ETE ( P<0.001) was a risk factor for postoperative recurrence in patients with DTC. Cox multivariate regression showed that ETE (HR: 10.564, 95% CI 3.712-30.063, P<0.001) was an independent risk factor for postoperative recurrence in patients with DTC. Conclusions:DTC accompanied by ETE is associated with risk factors such as large tumor diameter and multiple lesions, which has a lower 5-year DFS. Patients with the above characteristics should consider the possibility of ETE before surgery, and focus on long-term follow-up after surgery.
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Objective To explore the clinical results of benign thyroid nodule by ultrasound guided interventional radiofrequency ablation(RFA).Methods The radiofrequency ablation therapy was utilized to treat 129 patients with 149 thyroid nodules.The size and the related complications were observed during the follow-up.Using the t-test of paired design,the nodules volume decreased rate were calculated.Results At the 3rd and the 6th month after operation,all thyroid nodules in size to differert degree (P ＜0.05).Six patients felt pain in the neck.The pain was alleviated after ablation.Two patients had skin puncture site redness,which was cured after anti-inflammation treatment.There was no skin burn,perforation of the esophagus,trachea injury,hoarseness,bucking and other complications.Conclusions Ultrasound-guided RFA may be an effective and useful nonsurgical alternative in the treatment of thyroid nodules.It is clinically prospective for application.