Risk of Recurrence and Metastasis After Postoperative TSH Suppression Therapy for Differentiated Thyroid Cancer
WANG Ning
LIU Jinbiao
QIAO Nan
Abstract：Objective To investigate the factors associated with and predictors of recurrence and metastasis occurring after postoperative thyroid hormone(TSH)suppressive therapy failure in differentiated thyroid cancer(DTC).Methods A retrospective analysis was conducted on 282 patients with DTC admitted to the hospital from January 2017 to April 2020,who received TSH suppression therapy after surgery.The recurrence and metastasis status of the patients were analyzed for 3 years after surgery,and the relevant factors affecting recurrence and metastasis were analyzed.A nomographic prediction model was constructed.Results The incidence of recurrence and metastasis in 282 DTC patients 3 years after surgery was 14.54％(41/282).The number of lesions,tumor diameter,clinical stage,preoperative lymph node metastasis,postoperative risk stratification for recurrence,postoperative thyroglobulin(Tg)level,levothyroxine dose,and 131I therapy were the influencing factors for recurrent metastases occurring with treatment failure(P＜0.05).Logistic regression analysis showed that the number of lesions,tumor diameter,clinical stage,preoperative lymph node metastasis,postoperative risk stratification for recurrence,and postoperative Tg level were independent risk factors for recurrent metastasis in treatment failure,and levothyroxine dose and 131I treatment were independent protective factors for recurrent metastasis in treatment failure(P＜0.05).The area under the curve for predicting treatment failure,recurrence and metastasis of the column chart model was 0.943(95％CI:0.883-0.977).The calibration curve showed that the model consistency index was 0.843,and the model fit was good(P=0.441).Conclusion Number of lesions,tumor diameter,clinical stage,preoperative lymph node metastasis,postoperative risk stratification for recurrence,postoperative Tg level,levothyroxine dose,and 131I treatment are all predictors of recurrence and metastasis occurring after TSH suppressive therapy failure for DTC,and the developed column line graph prediction model has high risk prediction value,which has positive significance for reducing treatment failure.
Keywords：thyroid cancerdifferentiated typethyroid stimulating hormonepredictorsrecurrence and metastasisline graph
Publication Date：2023-12-31
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 4468-4473 )