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J Surg Oncol. 2016 Feb;113(2):152-8. doi: 10.1002/jso.24126. Epub 2015 Dec 14.

Changing trends in the clinicopathological features and clinical outcomes of medullary thyroid carcinoma.

Author information

1
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
2
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
3
Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
4
Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

BACKGROUND:

The early detection of papillary thyroid cancer has contributed to the increase in the incidence and improved clinical outcomes. However, recent changes of medullary thyroid carcinoma (MTC) over time remain unclear. We evaluated changes of the clinicopathological characteristics and clinical outcomes in patients with MTC in recent years.

METHODS:

A total of 109 MTC patients were classified based on the year of initial surgery: 1996-2000 (n = 14), 2001-2006 (n = 39), and 2007-2011 (n = 56).

RESULTS:

The primary tumor size significantly decreased and the proportion of microMTCs (size ≤1 cm) increased over time (P = 0.002 and P < 0.001, respectively). The proportion of patients with cervical lymph node (LN) metastasis significantly decreased (P = 0.037), and the ratio of metastatic LNs significantly decreased (P = 0.011). Disease-free survival (DFS) rate of patients was significantly improved over time (P = 0.007). There was no significant difference in DFS between microMTC and macroMTC patients. However, more advanced LN stage patients demonstrated more recurrences (P < 0.001). Especially, there were significantly more recurrences in patients with N1b diseases in comparison with patients without cervical LN metastases (P < 0.001).

CONCLUSIONS:

The prognosis of MTC patients has significantly improved in recent years. These changes could be associated with the early diagnosis before development of lateral and extensive cervical LN metastases. J. Surg. Oncol. 2016;113:152-158. © 2015 Wiley Periodicals, Inc.

KEYWORDS:

lymphatic metastasis; medullary thyroid carcinoma; prognosis; thyroid neoplasms; time

PMID:
26799259
DOI:
10.1002/jso.24126
[Indexed for MEDLINE]

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