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- Title
Postoperative biochemical remission of serum calcitonin is the best predictive factor for recurrence-free survival of medullary thyroid cancer: a large-scale retrospective analysis over 30 years.
- Authors
Jung, Kyong Yeun; Kim, Seok‐Mo; Yoo, Won Sang; Kim, Bup‐Woo; Lee, Yong Sang; Kim, Kyung Won; Lee, Kyu Eun; Jeong, Jong Ju; Nam, Kee‐Hyun; Lee, Se Hoon; Hah, Jeong Hun; Chung, Woong Youn; Yi, Ka Hee; Park, Do Joon; Youn, Yeo‐Kyu; Sung, Myung‐Whun; Cho, Bo Youn; Park, Cheong Soo; Park, Young Joo; Chang, Hang‐Seok
- Abstract
Context The increase in thyroid screening in the general population may lead to earlier detection of medullary thyroid carcinoma ( MTC). Objective We aimed to evaluate secular trends in clinicopathological characteristics and long-term prognosis of MTC and its prognostic factors. Design This was a retrospective analysis from 1982 to 2012. Patients Three hundred and thirty-one patients with MTC were included and grouped based on the year of diagnosis (1982-2000, 2001-2005, 2006-2010 and 2011-2012). Measurements These included recurrence and mortality as well as biochemical remission ( BCR) of serum calcitonin. Results Mean tumour size (from 2·5 cm to 1·7 cm, P < 0·001) and percentage of extrathyroidal extension (from 52·0% to 26·0%, P = 0·026) decreased. The percentage of patients achieving BCR within six postoperative months (po- BCR) increased with time (from 39·6% to 76·1%, P < 0·001). The 5-year overall recurrence rate significantly decreased in 2006-2012 compared to 1982-2005 (10% vs 18%, respectively, P = 0·031), although the 5-year survival rate did not improve (92% vs 92%, P = 0·929). Failure to achieve po- BCR was the strongest predictive factor associated with recurrence (hazard ratio [ HR] = 58·04, 95% CI 7·14-472·11; P < 0·001). Male gender ( HR = 3·18, 95% CI 1·18-8·56; P = 0·022), tumour size >2 cm ( HR = 18·33, 95% CI 2·35-143·06; P = 0·006) and distant metastasis ( HR = 4·00, 95% CI 1·31-12·21; P = 0·015) were significant prognostic factors for mortality. Conclusions Clinicopathological characteristics and recurrence of MTC improved with time. Po- BCR was the best predictive factor for recurrence-free survival.
- Subjects
MEDULLARY thyroid carcinoma; CALCITONIN; DISEASE relapse; THYROID cancer; PROGNOSIS
- Publication
Clinical Endocrinology, 2016, Vol 84, Issue 4, p587
- ISSN
0300-0664
- Publication type
Article
- DOI
10.1111/cen.12852