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
- Issue Date
- Apr-2016
- Publisher
- WILEY
- Citation
- CLINICAL ENDOCRINOLOGY, v.84, no.4, pp 587 - 597
- Pages
- 11
- Journal Title
- CLINICAL ENDOCRINOLOGY
- Volume
- 84
- Number
- 4
- Start Page
- 587
- End Page
- 597
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/64276
- DOI
- 10.1111/cen.12852
- ISSN
- 0300-0664
1365-2265
- Abstract
- ContextThe increase in thyroid screening in the general population may lead to earlier detection of medullary thyroid carcinoma (MTC). ObjectiveWe aimed to evaluate secular trends in clinicopathological characteristics and long-term prognosis of MTC and its prognostic factors. DesignThis was a retrospective analysis from 1982 to 2012. PatientsThree 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). MeasurementsThese included recurrence and mortality as well as biochemical remission (BCR) of serum calcitonin. ResultsMean tumour size (from 25cm to 17cm, P<0001) and percentage of extrathyroidal extension (from 520% to 260%, P=0026) decreased. The percentage of patients achieving BCR within six postoperative months (po-BCR) increased with time (from 396% to 761%, P<0001). The 5-year overall recurrence rate significantly decreased in 2006-2012 compared to 1982-2005 (10% vs 18%, respectively, P=0031), although the 5-year survival rate did not improve (92% vs 92%, P=0929). Failure to achieve po-BCR was the strongest predictive factor associated with recurrence (hazard ratio [HR] =5804, 95% CI 714-47211; P<0001). Male gender (HR=318, 95% CI 118-856; P=0022), tumour size >2cm (HR=1833, 95% CI 235-14306; P=0006) and distant metastasis (HR=400, 95% CI 131-1221; P=0015) were significant prognostic factors for mortality. ConclusionsClinicopathological characteristics and recurrence of MTC improved with time. Po-BCR was the best predictive factor for recurrence-free survival.
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