医学
甲状腺结节
入射(几何)
甲状旁腺机能减退
声带麻痹
不利影响
甲状腺
甲状腺癌
生活质量(医疗保健)
外科
麻痹
内科学
光学
物理
护理部
作者
Chunhao Liu,Hao Zhao,Yu Xia,Yue Cao,Liyang Zhang,Ya Zhao,Luying Gao,Ruifeng Liu,Yuewu Liu,Hongfeng Liu,Zhilan Meng,Shuzhou Liu,Ying Lü,Xiaoyi Li
出处
期刊:Ejso
[Elsevier BV]
日期:2023-04-25
卷期号:49 (9): 106917-106917
被引量:11
标识
DOI:10.1016/j.ejso.2023.04.016
摘要
Active surveillance (AS) is considered an alternative to immediate surgery (IS) for low-risk papillary thyroid microcarcinoma (PTMC) patients. However, it is difficult to decide between AS and IS due to limited evidence regarding risks and benefits for patients in China.This study prospectively enrolled 485 patients with highly suspicious thyroid nodules = 1 cm who chose AS and 331 patients who underwent IS during the same period. The oncological outcomes, adverse events and quality of life, were compared between the two groups.The oncological outcomes of the IS and AS groups were similarly excellent. The IS group had significantly higher rates of temporary vocal cord paralysis (VCP) and temporary hypoparathyroidism than the AS group (2.7% vs. 0.2%, p = 0.002; 13.6% vs.1.9%, p < 0.001, respectively). The IS group had significantly more patients on hormone replacement therapy (98.4% vs. 10.9%, p < 0.001) and a significantly higher incidence of neck scarring (94.3% vs. 9.1%, p < 0.001) compared to the AS group. In the early stages, the quality of life questionnaire showed significant differences with respect to three items: voice, throat/mouth, and surgical scarring, with more complaints in the IS group. However, one year or more after surgery, the main complaint was surgical scarring.In China, AS can achieve similar short-term therapeutic effects as IS. As this approach can reduce the occurrence of unfavorable events, achieve better quality of life, it is a feasible option for patients with highly suspicious thyroid nodules.
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