A multicenter, prospective study to observe the initial management of patients with differentiated thyroid cancer in China (DTCC study)

BMC Endocrine Disorders

Xing-Rui Li¹  Jie Ming²  Tao Huang²  Wen Tian³  Lei Xie⁴  Jun Wang⁵  Hui Sun⁶  Ruo-Chuan Cheng⁷  Hao Zhang⁸  Jing-Qiang Zhu⁹ 

[1] Department of Breast & Thyroid Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology;Department of Breast & Thyroid Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology;Department of General Surgery, Chinese PLA General Hospital;Department of Head & Neck Surgery, Sir Run Shaw Hospital, School of Medicine, Zhejiang University;Department of Head & Neck Surgery, The Tumor Hospital of Gansu Province;Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University;Department of Thyroid Surgery, First Affiliated Hospital of Kunming Medical University;Department of Thyroid Surgery, The First Hospital of China Medical University;Department of Thyroid Surgery, West China Hospital, Sichuan University;

关键词: Thyroid cancer;    Surgery;    Lymph nodes;    Guidelines;    Outcomes;    China;   

DOI  :  10.1186/s12902-021-00871-x

来源: DOAJ

【 摘 要 】

Abstract Background To assess the gaps between the initial management of patients with differentiated thyroid cancer (DTC) in real clinical practice and the recommendations of the 2012 Chinese DTC guidelines. Methods This multicenter, prospective study was conducted at nine tertiary hospitals across China. Eligible patients were those having intermediate or high-risk DTC after first-time thyroidectomy. During 1 year of follow-up, comprehensive medical records were collected and summarized using descriptive statistics. Results Of 2013 patients, 1874 (93.1%) underwent standard surgery according to the guidelines (including total lobectomy plus isthmusectomy and total/near total thyroidectomy), and 1993 (99.0%) underwent lymph node dissection; only 56 (2.8%) had postoperative complications. Overall, 982/2013 patients (48.8%) received radioactive iodine (RAI) therapy after thyroidectomy. Of all enrolled patients, 61.4% achieved the target serum thyroid-stimulating hormone level, with a median time to target of 234.0 days (95% CI: 222.0–252.0). At 1 year of follow-up, proportions of patients with excellent response, incomplete structural response, biochemical incomplete response, and indeterminate response were 34.6, 11.2, 6.6, and 47.5%, respectively; recurrence or metastasis occurred in 27 patients (1.3%). During the overall study period, 209 patients (10.4%) had at least one adverse event: 65.1% of cases were mild, 24.9% moderate, and 10.1% severe. Conclusions This was the first large-scale prospective study of how patients with DTC in China are treated in actual practice. Initial DTC management is generally safe and adheres to the 2012 Chinese guidelines but could be improved, and the level of guideline adherence did not produce the anticipated treatment response at 1 year of follow-up.

【 授权许可】

Unknown