A systematic literature review was conducted in PubMed and Web of Science databases for relevant studies published before January 31, 2023. Their reference lists were also analyzed. Two reviewers extracted data and evaluated the quality of eligible studies independently. Studies on patients who had open thyroidectomy procedures with or without neck dissection were included in this review. The RevMan 5.3 software was used to analyze the data.
This meta-analysis included thirteen studies with a total of 2075 patients. The following variables were associated with an increased risk of death in FTC patients: age > 45 years, male, tumor diameter > 4 cm, multifocality, extrathyroidal extension (ETE), widely invasive (WI), cervical lymph node metastasis (CLNM), distant metastases (DM) and non-radical resection tumor. Lobectomy and no radioactive iodine (RAI) treatment was not associated with the death of FTC patients.
Clinicians should pay closer attention to the following significant risk factors associated with the death of FTC patients: age (> 45), male, multifocality, tumor diameter > 4 cm, ETE, WI, non-radical resection tumor, CLNM, and DM. Individualized initial treatment and close follow-up are needed FTC patients who have these risk factors.
方法:在PubMed和WebofScience数据库中对2023年1月31日之前发表的相关研究进行了系统的文献综述。还分析了他们的参考列表。两名评审员提取数据并独立评估合格研究的质量。这篇综述包括对有或没有颈淋巴结清扫的开放式甲状腺切除术患者的研究。采用RevMan5.3软件进行数据分析。
结果:本荟萃分析包括13项研究,共2075名患者。以下变量与FTC患者死亡风险增加相关:年龄>45岁,男性,肿瘤直径>4厘米,多焦点,甲状腺外延伸(ETE),广泛侵入性(WI),颈淋巴结转移(CLNM),远处转移(DM)和非根治性切除肿瘤。肺叶切除术和无放射性碘(RAI)治疗与FTC患者的死亡无关。
结论:临床医生应密切关注以下与FTC患者死亡相关的重要危险因素:年龄(>45岁),男性,多焦点,肿瘤直径>4厘米,ETE,WI,非根治性切除肿瘤,CLNM,DM。有这些危险因素的FTC患者需要个体化的初始治疗和密切随访。