ABSTRACT
Objective To investigate the clinical prognostic features of pediatric differentiated thyroid carcinoma (DTC).Methods A retrospective analysis of clinical data of 56 cases of pediatric differentiated thyroid carcinoma under 14 years old admitted in our hospital from Aug.2009 to Oct.2018 was performed.KaplanMeier method and COX proportional hazards model were used to analyze the factors affecting the disease-free survival of patients.Results The follow-up period was from 6 months to 82 months,and the median follow-up time was 28 months.Recurrence occurred in 15 patients,with a survival rate of 100％.The 3-and 5-year disease-free survival rate was 67.4％ and 63.5％.Univariate analysis showed that tumor diameter ＞2 cm (P=0.046),multiple lesions (P＜0.001),cervical lymph node metastasis (P=0.008),and extra thyroidal extension (ETE) (P=0.035) were related factors affecting postoperative recurrence,while gender,age,Hashimoto's thyroiditis,tumor TNM stage,central lymph node metastasis and surgical approach were not related to postoperative recurrence.COX multivariate analysis showed that multiple lesions (HR:8.815,P=0.010) was the independent factor influencing the prognosis of pediatric differentiated thyroid carcinoma.Conclusions Multiple lesion is an independent influencing factor for the recurrence of pediatric differentiated thyroid carcinoma patients after surgery.Meanwhile,total thyroidectomy and long-term follow-up should be followed.Although the metastasis rate of lymph node and distant organ are high,overall prognosis is good in pediatric DTC.
ABSTRACT
Objective To prospectively evaluate the survival of different metastasis organs with concurrent chemotherapy and thoracic three-dimensional radiotherapy (CCTTRT) for stage Ⅳ non-small cell lung cancer (NSCLC).Methods Two hundred and one patients of stage Ⅳ NSCLC were enrolled from January,2003 to July,2010.Of the 182 patients eligible for analysis,The number of patients with single-organ metastasis or multiple-organ metastasis was 107 and 75,respectively.Patients were treated by platinum-based chemotherapy,the median number of cycle was 4.The median dose to planning target volume of primary tumor (DTPTv) was 63 Gy.Survival was calculated by Kaplan-Meier method and compared using the Logrank.Results The follow-up rate of 201 patients was 97.5％.with 201,170 and 134 patients finished ＜ 1,1 -2 and ≥3 years'follow up.Of 182 patients,the 1-,2-,and 3-year overall survival (OS) rate and median survival time (MST) was 41.0％,17.0％,10.0％ and 10.5 months,respectively ;with single-organ metastasis and multi-organ metastasis were 50％,20％,14％ and 13 months and 29％,12％,0％ and 8.5 months ( x2 =10.10,P =0.001 ),respectively; compared with multi-organ metastasis,the 1-,2-,and 3-year OS arte and MST of patients with bone,lung metastasis only was 58％,25％,16％ and 14 months (x2 =10.42,P=0.001 ) and 49％,21％,21％ and 11 months (x2 =6.39,P=0.011 ) respectively;patients with brain metastasis only did not show advantage of survival comparing with patients with multi-organ metastasis (49％,8％,0％ and 12 months and 29％,12％,0％ and 8 months,respectively;x2 =0.71,P =0.401 ) ;the 1-,2-,and 3-year OS rate and MST was 63％,23％,19％ and 15 months and 42％,15％,0％ and 10 months,respectively for patients with single-organ metastasis and multi-organ metastasis patients who accepted 4 - 5 cycles of chemotherapy ( x2 =6.47,P =0.011 ) ; for patients under the same metastasis and 4 - 5 cycles of chemotherapy,no matter whether single-organ or multiple-organ metastases,the 1 -,2-,3-year OS rate and MST of patients with enough radiotherapy on DTPTV ≥63 Gy were better than patients without enough radiotherapy ( DTPTV ＜ 63 Gy ) ( 71％,25 ％,25％ and 16.8 months and 33％,17％,0％ and 10.5 months,respectively;x2 ＝4.73,P =0.030 ;54％,21％,0％ and 14.3 months and 29％,10％,0％ and 7.6 months,respectively,x2 =8.16,P =0.004).The MST of liver metastases was 6 months,there was significantly difference when comparing with non liver matastasis ( x2 =17.21,P =0.000).Conclusions It is very important to treat stage Ⅳ NSCLC with CCTTRT,especially patients with single-organ metastasis.Liver metastases is a unfavorable prognostic factor.