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Titolo:
DIFFERENTIATED THYROID-CANCER - REEXAMINATION OF RISK GROUPS AND OUTCOME OF TREATMENT
Autore:
SANDERS LE; CADY B;
Indirizzi:
LAHEY HITCHCOCK MED CTR,DEPT GEN SURG,41 MALL RD BURLINGTON MA 01805 NEW ENGLAND DEACONESS HOSP,DEPT GEN SURG BOSTON MA 00000
Titolo Testata:
Archives of surgery
fascicolo: 4, volume: 133, anno: 1998,
pagine: 419 - 424
SICI:
0004-0010(1998)133:4<419:DT-ROR>2.0.ZU;2-U
Fonte:
ISI
Lingua:
ENG
Soggetto:
PROGNOSTIC SCORING SYSTEM; FOLLICULAR CARCINOMA; PAPILLARY CARCINOMA; MANAGEMENT; CLASSIFICATION; LOBECTOMY; THERAPY; IMPACT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
31
Recensione:
Indirizzi per estratti:
Citazione:
L.E. Sanders e B. Cady, "DIFFERENTIATED THYROID-CANCER - REEXAMINATION OF RISK GROUPS AND OUTCOME OF TREATMENT", Archives of surgery, 133(4), 1998, pp. 419-424

Abstract

Objective: To reexamine the age, metastases, extent, and size (AMES) risk criteria for well-differentiated thyroid cancer with the effect of therapy on outcome. Design: Review of patient medical records and direct-contact follow-up. Setting: Two tertiary referral centers. Main Outcome Measures: Recurrence or death. Patients: One thousand nineteen patients with well-differentiated thyroid cancer treated between 1940 and 1990. Results: One thousand nineteen patients with well-differentiated thyroid cancer were treated between 1940 and 1990, with a mean follow-up of 13 years, including a recent group of 264 patients treated from 1980 to 1990 at 2 different institutions with a mean follow-up of8 years. The AMES criteria were used to designate high-and low-risk patients. The entire group had 229 high-and 790 low-risk patients; the percentage of high-risk patients de creased slightly after 1960. From 1940 to 1960, 1960 to 1979, and 1980 to 1990, the high-risk groups hadsurvival rates of 48%, 62%, and 47%, respectively. For the low-risk patients, survival rates were 96%, 98%, and 98%, respectively. Recurrences occurred in 5% of low-risk patients and were usually curable; in high-risk patients, recurrence was associated with a 75% mortality. In low-risk patients, there was no significant difference in recurrence or death according to type of operation (unilateral or bilateral) or use of radioactive iodine. In high-risk patients, there were trends toward but no significant improvement in survival with bilateral sugery and radioactive iodine therapy; thyroid replacement was associated with a significant improvement in survival. Conclusions: The AMES risk criteria remain highly valid predictors of risk. They define most low-riskpatients for whom radical treatment may add excess morbidity but not improve already excellent prognoses.

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Documento generato il 09/07/20 alle ore 23:53:32