When you are diagnosed with thyroid cancer , you will inevitably have a lot of confusion in your heart. What is my prognosis? Will it recur? Is life-threatening? Today I will use the following four keywords to solve differentiated thyroid cancer:
Grading: Predict your risk of recurrence
efficacy : Judge your therapeutic effect
Years: Track your disease changes
Stage: Predict your risk of death
Grading: Predict your risk of death
Grading
When you have the surgery, the doctor will divide your recurrence risk into low, medium and high levels based on your pathological report. We have revealed the truth about the recurrence of thyroid cancer. The so-called high risk of recurrence actually means that there is a high probability of residual lesions.
There are many articles on the Internet about recurrence risk assessment, all of which are translated into the US guidelines. I believe you don’t want to read it if I listed it. I will simply say it in my own words:
Recurrence risk classification
Low risk
Low risk refers to the neck whether there is no metastasis, or a little lymph node metastasis or extragastral invasion. Because there are few metastatic lesions, the probability of residuals is small and the recurrence rate is low (10%).
medium risk
medium risk refers to a certain degree of metastasis in the neck, such as some lymph node metastasis visible to the naked eye or the primary tumor invades the muscles in the front of the neck, but there is no doubt about problems outside the neck. Because there are some metastatic lesions on the neck, there may be local residues, and therefore there is a certain recurrence rate (=20%).
High risk
High risk refers to a large-scale metastasis in the neck, such as a large lymph node metastasis or the primary invasion of a key part. Because there are a large number of metastatic lesions on the neck, the risk of residual lesions on the neck and outside the neck is often difficult to avoid, and therefore there is a high recurrence rate (30%) .
efficacy
efficacy, as the name suggests, refers to the effect of treatment. The initial disease status of the two people may be the same, but the treatment effect is different.
For example: A patient with aratopic cancer has a very wide range of metastasis, and his surgeon can completely clean the tumor; another patient with aratopic cancer has a very wide range of metastasis, and his surgeon opens his neck and closes it, and he can do nothing. The prognosis of these two patients is completely different.
Another example: A patient with lung metastasis , but the lungs absorb iodine well, and the tumor index dropped rapidly; another patient with erectile dysfunction, but the lungs do not absorb iodine, and the tumor index rose rapidly. The prognosis of these two people is also completely different. The efficacy of
Acrystallaria often depends on the level of your surgeon and the ability of your tumor to take iodine into its own.
years
Many people pay attention to the grading and treatment effects of tumors, but they all ignore another key theme: time. Aratoplasty is a chronic disease. Can your aratoplasty be able to withstand the test of time and remain stable?
Let’s take a look at an example at the 2016 World Thyroid Conference:
39-year-old male patient found a cervical vertebrae tumor due to neck pain, and the puncture showed thyroid follicular cancer bone metastasis ;
bone scan found bone metastasis at C6 and T6. C6 and external radiotherapy were performed. External radiotherapy was performed at C6 and external radiotherapy at T6.
thyroid resection was totally removed and follicular cancer was found. The TG was discontinued during iodine treatment at
. The TG was as high as 3220. After
, the first 250 Haoju iodine treatment was performed, and TG32 was performed after iodine;
, the second 258 Haoju iodine treatment was performed after iodine, and TG20 was performed after iodine;
, the third 258 Haoju iodine treatment was performed after iodine, and TG12 was performed after iodine;
no longer took iodine, and the treatment was completed.
There is no doubt that he is a high-risk thyroid cancer and has not achieved complete remission after treatment. But...
iodine treatment in the past five years, his TG dropped to 9;
iodine treatment in the past ten years, his daughter graduated from college, and his TG dropped to 6.2;
iodine treatment in the past fifteen years, his daughter got married, and his TG dropped to 5.2.
This is the years.
Many times your thyroid cancer is coming in full force and cannot be completely relieved after treatment, but it remains stable after years of experience, and you can still live like a normal person.
stage
When combining grading, efficacy and years, you will also know the survival rate of a patient with A-cancer. Staging is to evaluate the survival rate of thyroid cancer based on age and the metastasis range of the disease:
stage
stage 0stage is patients who are younger than 55 years old and patients who are older than 55 years old without metastasis. Most patients have first-stage A-carcinoma, and the ten-year survival rate of first-stage A-carcinoma is as high as 98-100%.
second phase
second phase is patients with distant transgression at age less than 55 years old and patients with a certain degree of neck metastasis at age older than 55 years old. The ten-year survival rate of stage 2 anaerobic cancer is as high as 85-95%.
stage 3
stage 3 is a patient who is older than 55 years old and has an invasion of the recurrent laryngeal nerve, trachea, and esophagus. The ten-year survival rate of stage 3 A-carcinoma is 60-70%.
Phase 4
Phase 4 is a patient who is older than 55 years old and cannot be surgically removed or has a distant resection. The ten-year survival rate of stage 4 aphrodisiac is less than 50%.
Many people are curious why age affects the survival rate of A-cancer? The reason has been explained in the article: a young patient and an elderly patient have the same grading (risk of recurrence), but young patients are more likely to have good efficacy (good iodine is good), and tumors are not likely to change due to the passage of time, so their staging (mortality rate) is relatively lower than that of elderly patients.
