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 a overview of the origins, development of conditional survival and its application to thyroid cancer and prospects the future orientation of research.
ObjectiveTo explore and analyze the current situation of discharge readiness and delayed discharge for patients undergoing ambulatory thyroid malignancy surgery.MethodsBy convenient sampling, 284 thyroid malignancy patients who were admitted to the day surgery ward of Xiangya Hospital, Central South University from September 1st to December 30th, 2018 were selected as the research objects. The general information questionnaire and Readiness for Hospital Discharge Scale (RHDS) were used as the research tools. Descriptive statistical analysis was used to analyze the demographic statistics of the patients, and the differences of different dimension scores and total scores of RHDS were analyzed based on the basic information of patients.ResultsThe total score of RHDS was 8.66±0.60 for patients, including 6.31±0.74 for dimension of physical condition, 9.49±0.87 for dimension of disease knowledge, 9.20±0.99 for dimension of coping ability after discharge, and 9.63±0.74 for dimension of expected social support. The delayed discharge rate was 2.1%. There was no significant difference in the scores of different dimensions or total scores in RHDS of patients undergoing ambulatory thyroid malignancy surgery with different gender, age, education level or whether there was a special person to take care of them (P>0.05). There were differences between patients with delayed discharge and the ones without delayed discharge in the three dimensions namely physical condition, disease knowledge, and coping ability, as well as the total scores (P<0.05), while there was no statistically significant difference in the scores of expected social support dimension (P>0.05).ConclusionsThe discharge readiness for patients undergoing ambulatory thyroid malignancy surgery is good. The medical staff should provide health intervention measures according to the specific situation of patients, so as to improve the quality of discharge guidance, and ensure the safety of patients.
Objective To discuss the relationship between thyroid stimulating hormone (TSH) and clinicopathologic features of the papillary thyroid microcarcinoma (PTMC) patients. Methods The thyroid nodules of 806 cases retrospectively that were for the first time hospitalized to our department in recent 5 years were collected, among them, postoperative pathological examination confirmed the diagnosis of PTMC in 403 cases, 403 cases of benign thyroid lesions, the history data of selected cases that meet the criterion of selection were retrospectively analyzed. TSH and anti thyroid globulin antibody (TGAb) levels between the 2 groups and the prevalence of ratio of PTMC in different TSH levels were compared. Univariate and multivariate analysis were performed to determine the risk factors of PTMC. Results The differences of preoperative TSH levels between the two groups was statistical significance (Z=–6.233,P=0.001), gender composition no statistical significance in two groups (χ2=3.246,P=0.072), and age was statistically significant (Z=–5.855,P=0.001). The constitution of ethnics of two groups was different (χ2=38.961,P=0.001). Logistic regression analysis display that age and TSH level were the independent risk factors of PTMC (age:OR=0.914,P=0.027; TSH:OR=4.662,P=0.008). Conclusions The level of serum TSH in PTMC patients is higher than in patients with benign thyroid nodules. TSH level is probably predictive of malignancy of PTMC.