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- Title
Small medullary thyroid carcinoma: post-operative calcitonin rather than tumour size predicts disease persistence and progression.
- Authors
Saltiki, Katerina; Rentziou, Gianna; Stamatelopoulos, Kimon; Georgiopoulos, Georgios; Stavrianos, Charalambos; Lambrinoudaki, Eirini; Alevizaki, Maria
- Abstract
Objective: Recently, small medullary thyroid carcinomas (smallMTCs ; ≤ 1.5 cm) are frequently diagnosed, occasionally as incidental findings in surgical specimens. Their clinical course c varies. We examined tumour size as a predictor of clinical behaviour. Design: A retrospective study. Methods: A total of 128 smallMTC patients (35.2% males and 45% familial) were followed up for 0.9-30.9 years. According 15 to tumour size (cm), patients were classified into four groups: group 1, 0.1-0.5 (n = 33); group 2, 0.6-0.8 (n = 33); group 3, 01 0.8-1.0 (n = 29) and group 4, 1.1-1.5 (n = 33). Results: Pre- and post-operative calcitonin levels were positively associated with the tumour size (P<0.001). Capsular and Slymph node invasion were more frequent in groups 3 and 4 (P<0.03); the stage was more advanced and the outcome was less 1 favourable with an increasing tumour size (P<0.001). Groups 1 and 2 patients were more frequently cured (group 1, 87.8%; m group 2, 72.7%; group 3, 68.9%; and group 4, 48.5%; P=0.002). The 10-year probability of lack of disease progression according to the tumour size differed between patients with tumour sizes of 0.1-1.0 and 1.1-1.5 cm (96.6%, 81.3%, x² = 4.03, P=0.045 for log-rank test). Post-operative calcitonin was the only predictor significantly associated with the 10-year progression of disease. Post-operative calcitonin levels ≥4.65 pg/ml predicted disease persistence (sensitivity 93.8% and specificity 90%) and ≥14.5 pg/ml predicted disease progression (sensitivity 100%, specificity 82%, receiver operating characteristic curve analysis). Conclusions: Tumour size may be of clinical importance only in patients with MTCs > 1 cm in size. Post-operative calcitonin is a more important predictor than size for disease progression.
- Subjects
MEDULLARY thyroid carcinoma; CANCER invasiveness; POSTOPERATIVE care; CALCITONIN; HEALTH outcome assessment; CANCER patients
- Publication
European Journal of Endocrinology, 2014, Vol 171, Issue 1, p117
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-14-0076