| Objective:To assess survival status of the inpatients with stage IV differentiated thyroid cancer treated by the different treatment using survival analysis, and to provide the basis for recommendations on the formulation of thyroid cancer treatment guidelines.Methods:Follow-up study was conducted to analyze the survival data of inpatients with stage IV differentiated thyroid cancer from January1992to December2005. The study information included patients’ features, such as age, gender, employment status and marriage status, as well as diagnosis, treatment and follow-up information. Measurement data was described with mean, median, and standard deviation and quartile. The differences between the groups were compared using the Mann-Whitney U test, Kruskal-Willis H test and95%confidence interval for statistical inference; respectively. Proportion was used to describe the categorical data, and group comparison used the chi-square test or rank sum test. Survival analysis was conducted to describe survival time, rate and curve. Cox proportion hazard model was performed to adjust the co-variable in assessing the effect of the different treatment projects. All analysis was performed by SPSS18.0statistics software, and All statistical hypothesis testing was the two-sided test, and P<0.05was defined statistically significant. Results:A total of43inpatients with stage IV differentiated thyroid cancer were followed-up and analyzed, and27cases with surgery1311treatment of TSH suppression therapy for comprehensive therapy group,.16cases with surgery TSH suppression therapy for conventional treatment group. Findings showed that Among patients with the clinical stage4, the average survival time (median=182months) of patients with surgery1311therapy for TSH suppression treatment of the comprehensive therapy group was longer than survival time (median=57months) of patients with surgery TSH suppression therapy for conventional treatment group(x2=7.131,P=0.008). The survival rate in5years and10years were59%and59%in patients with comprehensive treatment, and31.2%,0.0%in patients with conventional treatment, respectively, and there were statistically different among groups(P<0.05). After adjusting for the confounding factors such as gender, age, employment, marriage, culture, findings from Cox model showed that the survival status of patients with different treatments were statistically different (x2=4.528, P=0.033).the affection on the survival status of comprehensive treatment was3.1times as that of conventional treatment.Conclusion:The median survival time of patients with surgery combined with1311treatment and TSH of the comprehensive therapy group was greater than that of the surgery combined with TSH suppressive therapy of the conventional treatment group. Surgery combined with1311treatment and TSH of the comprehensive therapy was more useful for prolonging the survival time and promoting the survival rate in long time. The results implied that surgery combined with1311treatment and TSH of the comprehensive therapy should be recommended in the treatment of inpatients with stage IV differentiated thyroid cancer. |
PDF Full Text Request