Analysis of the perioperative risk and prognosis of patients with differentiated thyroid cancer complicated by Graves’ disease
10.3760/cma.j.cn115807-20250127-00043
- VernacularTitle:Graves病合并分化型甲状腺癌患者的围手术期风险及预后分析
- Author:
Zijing LIU
1
;
Bing WANG
1
;
Chen LI
1
;
Zheng WAN
1
;
Yanbing JIAN
1
;
Jing YAO
1
;
Wen TIAN
1
Author Information
1. 解放军总医院第一医学中心普通外科医学部甲状腺疝外科，北京 100853
- Publication Type:Journal Article
- Keywords:
Graves’ disease;
Differentiated thyroid cancer;
Perioperative period;
Prognosis
- From:
Chinese Journal of Endocrine Surgery
2025;19(2):227-232
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the perioperative risks and prognosis in patients with differentiated thyroid cancer (DTC) complicated by Graves' disease (GD) .Methods:Clinical data of 880 DTC patients who underwent radical thyroidectomy at the Department of General Surgery, the First Medical Center of Chinese PLA General Hospital between Jan. 2016 and Dec. 2022 was retrospectively collected. The cohort included 119 DTC patients with GD (hyperthyroid group) and 761 DTC patients with normal thyroid function without GD (normal group) . Use propensity score matching (PSM) was used to obtain cohorts with balanced baseline characteristics between the hyperthyroid and normal groups. Perioperative risks and prognos were compared between the two groups.Results:For perioperative risk comparison, after 1∶2 matching, 116 patients were included in the hyperthyroid group and 232 patients in the normal group. The operation time was longer in the hyperthyroid group compared to normal group ([107.26±30.27]min vs. [96.45±32.51]min, P=0.003) . There were no statistical differences between the two groups in intraoperative blood loss, postoperative drainage volume or postoperative hospital stay ( P>0.05) . There were no statistical difference in the incidence of complications such as temporary or permanent hypoparathyroidism, temporary or permanent recurrent laryngeal nerve injury, and lymphatic leakage between the two groups. For prognostic comparison, after 1∶2 matching, 117 cases were included in the hyperthyroid group and 234 cases in the normal group. During follow-up period, 16 patients experienced DTC recurrence, including 5 cases in the hyperthyroid group and 11 cases in the normal group. There was no statistical difference in reccurence-free survival rates between the two groups (5-year RFS: 95.7% vs. 95.3%, P=0.907) . Multivariate Cox regression analysis revealed GD was not the risk factor for DTC recurrence. Conclusions:With standardized and adequate preoperative preparation, the perioperative risks of DTC patients complicated by GD were not increased compared to patients without GD. Additionally, GD does not increase the risk of postoperative tumor recurrence in DTC patients.
