Thyroid cancer is the most common malignancy of the head and neck region and the endocrine system, with its incidence increasing rapidly worldwide. While the overall prognosis of thyroid cancer is favorable, patients with high-risk features (e.g., extensive extrathyroidal extension or distant metastasis) or specific histologic types (e.g., anaplastic cancer) exhibit significantly poorer outcomes. Traditional survival analysis only provides static estimates of survival rates (e.g., 5- or 10-year survival) from the time of diagnosis or surgery. However, mortality risk dynamically changes over time, rendering such static measures inadequate for assessing evolving prognosis—particularly for patients who have already survived for a certain period after treatment. Conditional survival serves as a dynamic prognostic tool, quantifying the probability that a patient who has already survived x years will survive an additional y years. Understanding and utilizing conditional survival is critical for both clinicians and patients that it informs therapeutic decision-making and follow-up strategies for clinicians, while empowering patients to make informed life plans based on evolving survival expectations. Hence, we present an overview of the origins, development of conditional survival and its application to thyroid cancer and prospects the future orientation of research.
ObjectiveTo investigate the early diagnosis and proper treatment of acute mesenteric venous thrombosis (AMVT).
MethodsThe clinical data of 105 cases of AMVT treated from January 2000 to December 2013 were analyzed retrospectively.
ResultsThe diagnostic accuracy of ultrasonography and abdominal contrast-enhanced CT was 67.6% (71/105), 88.0% (81/92) respectively. The accuracy rate of abdominal cavity puncture or abdominal drainage in the diagnosis of intestinal necrosis was 100% (38/38). All cases received anticoagulation and thrombolysis as soon as the definite diagnosis of AMVT were made. Twenty-five cases underwent emergency operation due to the bowel necrosis at the visiting time, Anticoagulation and thrombolysis were performed in 80 patients, of which 7 patients received surgical treatment because of ineffective anticoagulation and thrombolytic therapy. Thrombectomy was performed in 15 cases simultaneously. Surgical treatment of 32 cases, 30 cases were cured and 2 patients died of multiple organ failure or short bowel syndrome within 1 month after operation. Seventy-three cases were treated with anticoagulation therapy alone, 72 patients were cured and discharged, the effective rate was 90.0%, another 1 case died due to cerebral hemorrhage within 1 month after operation.
ConclusionsEarly diagnosis of AMVT and bowel necrosis, timely and accurate anticoagulation and thrombolysis, and proper surgical intervention can often achieve satisfactory results.
ObjectiveTo investigate the clinical value of elective central compartment lymph node dissection for cN0 papillary thyroid carcinoma.
MethodThe clinical data of 326 patients with cN0 papillary thyroid carcinoma from January 2007 to December 2011 in this hospital were analyzed retrospectively.
ResultsThe lymph node metastasis incidence was 35.89%(117/326) in 326 patients with cN0 papillary thyroid carcinoma, which in the patients with age < 45 years, tumor diameter > 1 cm, and thyroidal tumor infiltrated envelope were significantly higher than those in the pati-ents with age≥45 years, tumor diameter≤1 cm, and thyroidal tumor not-infiltrated envelope (age:46.56% versus 28.72%, P=0.001;tumor diameter:44.44% versus 26.45%, P=0.001;infiltrated envelope:50.00% versus 33.09%, P=0.020).Multivariate analysis showed that age < 45 years and tumor diameter > 1 cm were independent risk factors for central compartment lymph node metastasis of cN0 papillary thyroid carcinoma.There were 6 cases of temporary recu-rrent laryngeal nerve injury, 18 cases of temporary hypoparathyroidism, 4 cases of temporary superior laryngeal nerve injury, and 1 case of acute caryngeal edema.There were no complications such as permanent laryngeal nerve injury and permanent hypoparathyroidism.Three cases had lateral cervical lymph node metastases during a follow-up of 7-67 months (mean 31.2 months).
ConclusionsIt is necessary and safe to perform elective central compartment lymph node dissec-tion for cN0 papillary thyroid carcinoma.The elective central compartment lymph node dissection should be considered in patients with cN0 papillary thyroid carcinoma, especially in patients with age of < 45 years and tumor diameter > 1 cm.
ObjectiveTo analyze the relevant factors of levelⅡlymph node metastasis in papillary thyroid carci-noma.
MethodsThe clinicopathologic data of 83 patients from November 2011 to March 2014 were analyzed retrospec-tively. All the primary tumors were papillary thyroid carcinoma located in unilateral lobe with ipsilateral lateral neck lymph node metastasis. The relationship of gender, age, microcarcinoma, superior pole involved by carcinoma, integrated tumor capsule, or extranodal invasion to levelⅡlymph node metastasis was analyzed. The calculated data were analyzed with Chi-Square test and there was significant difference when P < 0.05.
ResultsThe rate of lymph node metastasis at levelⅡ, Ⅲ, Ⅳ, Ⅴ, Ⅵwas 51.8% (43/83), 78.3% (65/83), 71.7% (59/83), 4.8% (4/56), and 79.5% (66/83), respectively. There was no significant relationship of gender, age, microcarcinoma, integrated tumor capsule, or extranodal invasion to levelⅡlymph node metastasis (P > 0.05). The rate of lymph node metastasis at levelⅡwas significantly higher when superior pole involved by carcinoma (P < 0.05).
ConclusionAmong the patients with papillary thyroid carcinoma, when superior pole involved by carcinoma the patient should be underwent selective neck dissection, the proper extent of dissection including levelⅡshould be performed.
