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Thyroid. 2019 Mar;29(3):368-377. doi: 10.1089/thy.2018.0564. Epub 2019 Jan 31.

Survival and Long-Term Biochemical Cure in Medullary Thyroid Carcinoma in Denmark 1997-2014: A Nationwide Study.

Author information

1
1 Department of ORL-Head & Neck Surgery and Audiology, Odense University Hospital, Odense, Denmark.
2
2 Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
3
3 Department of Clinical Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
4
4 Steno Diabetes Center North Jutland, Gentofte, Denmark.
5
5 Department of Internal Medicine and Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
6
6 Center for Rare Diseases, Aalborg University Hospital, Aalborg, Denmark.
7
7 Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark.
8
8 Department of ORL-Head & Neck Surgery and Aarhus University Hospital, Aarhus, Denmark.
9
9 Department of ORL-Head & Neck Surgery, Aalborg University Hospital, Aalborg, Denmark.
10
10 Department of ORL-Head & Neck Surgery, and Copenhagen University Hospital, Copenhagen, Denmark.
11
11 Department of Oncology, Herlev Hospital, Herlev, Denmark.
12
12 Odense Patient data Explorative Network (OPEN), Odense University Hospital, Odense, Denmark.
13
13 Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark.
14
14 Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
15
15 Department of Clinical Genetics, Odense University Hospital, Odense, Denmark.

Abstract

BACKGROUND:

Survival of medullary thyroid carcinoma (MTC) subgroups in relation to the general population is poorly described. Data on the factors predicting long-term biochemical cure in MTC patients are nonexistent at a population level. A nationwide retrospective cohort study of MTC in Denmark from 1997 to 2014 was conducted, aiming to detect subgroups with survival similar to that of the general population and to identify prognostic factors for disease-specific survival and long-term biochemical cure.

METHODS:

The study included 220 patients identified from the nationwide Danish MTC cohort between 1997 and 2014. As a representative sample of the general population, a reference population matched 50:1 to the MTC cohort was used.

RESULTS:

Patients diagnosed with hereditary MTC by screening (hazard ratio [HR] = 1.5 [confidence interval (CI) 0.5-4.3]), patients without regional metastases (HR = 1.4 [CI 0.9-2.3]), and patients with stage I (HR = 1.3 [CI 0.6-3.1]), stage II (HR = 1.1 [CI 0.6-2.3]), and III (HR = 1.3 [CI 0.4-4.2]) disease had an overall survival similar to the reference population. On multivariate analysis, the presence of distant metastases (HR = 12.3 [CI 6.0-25.0]) predicted worse disease-specific survival, while the absence of regional lymph node metastases (odds ratio = 40.1 [CI 12.0-133.7]) was the only independent prognostic factor for long-term biochemical cure.

CONCLUSIONS:

Patients with hereditary MTC diagnosed by screening, patients without regional metastases, and patients with stages I, II, and III disease may have similar survival as the general population. The presence of distant metastases predicted worse disease-specific survival, while the absence of regional metastases predicted long-term biochemical cure.

KEYWORDS:

Denmark; biochemical cure; medullary thyroid carcinoma; nationwide; population-based; survival

PMID:
30618340
DOI:
10.1089/thy.2018.0564

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