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- Title
Spontaneous Deceleration and Acceleration of Growth Rate in Medullary Thyroid Carcinomas Suggested by Changes in Calcitonin Doubling Times Over Long-Term Surveillance.
- Authors
Miyauchi, Akira; Kudo, Takumi; Kihara, Minoru; Oda, Hitomi; Ito, Yasuhiro; Miya, Akihiro
- Abstract
Background: Based on our long-term observation of medullary thyroid carcinoma (MTC) patients, we hypothesized that some MTCs have spontaneous deceleration or regression of tumor growth over a long term and that a minority may acquire growth acceleration. We thus compared the calcitonin doubling time (Ct-DT) in the earlier and later half-periods of MTC patients' postoperative course.Methods: We followed 26 MTC patients (14 hereditary and 12 sporadic MTCs) with postoperative hypercalcitoninemia with periodic measurements of serum calcitonin (Ct) for >10 years without major interventions. The median period of Ct measurements was 18.3 years (range 10.6-30.2 years). We divided the individual patients' study periods into the earlier and later halves and calculated the Ct-DTs for both periods.Results: In the hereditary group, the Ct-DT in the later half-period (Later-Ct-DT) was significantly longer than that in the earlier half-period (Earlier-Ct-DT) (median 20.0 years vs. 7.1 years, p = 0.013). These values in the sporadic group were 20.0 years versus 11.1 years, respectively (p =0.774). Twelve patients (seven hereditary and five sporadic) had Later-Ct-DTs significantly longer than their Earlier-Ct-DTs (median 27.4 years vs. 4.9 years) and good prognoses. Two patients (one hereditary, one sporadic) had Later-Ct-DTs significantly shorter than their Earlier-Ct-DTs, and both developed structural recurrence and died of the disease.Conclusion: Many of the hereditary and some of the sporadic MTC patients had elongated Ct-DTs over a long period, suggesting spontaneous deceleration and regression of tumor growth. A minority of the MTC patients showed Ct-DT shortening, suggesting tumor growth acceleration.
- Subjects
MEDULLARY thyroid carcinoma; TUMOR growth; SERUM; CALCITONIN; PATIENTS
- Publication
World Journal of Surgery, 2019, Vol 43, Issue 2, p504
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-018-4789-1