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Changing trends in the clinicopathological features and clinical outcomes of medullary thyroid carcinoma
Author(s) -
Kwon Hyemi,
Kim Won Gu,
Sung TaeYon,
Jeon Min Ji,
Song Dong Eun,
Lee YuMi,
Yoon Jong Ho,
Chung KiWook,
Hong Suck Joon,
Baek Jung Hwan,
Lee Jeong Hyun,
Kim Tae Yong,
Shong Young Kee,
Kim Won Bae
Publication year - 2016
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24126
Subject(s) - medicine , thyroid carcinoma , stage (stratigraphy) , incidence (geometry) , medullary cavity , lymph node , thyroid , thyroid cancer , metastasis , gastroenterology , urology , cancer , oncology , paleontology , physics , optics , biology
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.