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摘要
Background: Recent studies have reported improved survival in patients with thyroid cancer. This study evaluated the changes in disease-specific survival (DSS) of patients with differentiated thyroid cancer (DTC) in association with clinicopathologic characteristics from 1996 to 2005 in Korea.
Methods: This was a retrospective, multicenter cohort study. A total of 4398 DTC patients were included, and they were classified according to the year of initial surgery: 1996-2000 (period 1), 2001-2003 (period 2), and 2004-2005 (period 3).
Results: During the study period, patient age and the proportion of papillary thyroid cancer increased gradually. Primary tumors became smaller (2.3 +/- 1.4cm at period 1 to 1.5 +/- 1.2cm at period 3; p<0.001). The proportion of high-volume lymph node metastases decreased significantly (20% at period 1 to 13% at period 3; p for trend <0.001). DSS differed significantly according to period during the median 10 years follow-up (p=0.002). The 10-year DSS rates were 98.0%, 98.7%, and 99.2% in periods 1, 2, and 3, respectively. After adjusting for various characteristics, the disease-specific mortality risk was significantly lower during period 2 (hazard ratio=0.49 [confidence interval CI 0.25-0.90], p=0.021) and period 3 (hazard ratio=0.40 [confidence interval 0.21-0.77], p=0.006) compared to that of period 1. This trend was also significant in a subgroup analysis of low (I-II) and high (III-IV) TNM stages.
Conclusions: The disease-specific mortality of patients with DTC in Korea decreased over time. Earlier detection of small DTCs with less extensive disease and standardization of treatment may be associated with this phenomenon.
- 出版日期2018-9
