Clinical Characteristics, Surgical Management, and Prognostic Factors of Medullary Thyroid Carcinoma: A Retrospective, Single-Center Study

医学 阶段(地层学) 恶性肿瘤 淋巴血管侵犯 累积发病率 内科学 单中心 多元分析 回顾性队列研究 甲状腺癌 淋巴结 单变量分析 胃肠病学 甲状腺 癌症 转移 队列 古生物学 生物
作者
Xin Wu,Binglu Li,Congyi Zheng
出处
期刊:Technology in Cancer Research & Treatment [SAGE Publishing]
卷期号:21: 153303382210784-153303382210784 被引量:5
标识
DOI:10.1177/15330338221078435
摘要

Purpose: Medullary thyroid carcinoma (MTC) is a rare neuroendocrine malignancy with relatively early lymphatic metastatic spread. The clinical features of MTC remain controversial owing to the low incidence rate. This study aimed to analyze the clinical characteristics, prognostic factors, and long-term follow-up of MTC. Methods: Medical records of MTC patients treated at our hospital between December 2000 and November 2020 were reviewed retrospectively. Clinicopathologic features of MTC were analyzed using univariate and multivariate analyses. Cumulative survival rates were estimated using the Kaplan-Meier method. Results: In total, 152 patients with MTC were included. The rates of central and lateral lymph node metastases (LNM) were 52.0% and 42.8%, respectively. All patients were followed up with a median follow-up time of 43.5 (17.0−76.3) months. Univariate and multivariate analyses identified two independent factors associated with progressive disease. They were lateral LNM (p < 0.001) and lymph node ratio (LNR) >1/3 (p = 0.009). The 5-, 10-, and 15-year cumulative overall survival (OS) rates of MTC were 88.2%, 83.1%, and 76.2%, respectively. The 5-, 10-, and 15-year cumulative disease-free survival (DFS) rates were 61.8%, 48.6%, and 38.2%, respectively. Patients with stage I, II, and III disease had significantly longer OS and DFS than those with stage IV disease (p < 0.001). Conclusion: MTC is a rare endocrine malignancy and LNM is common. Patients with lateral LNM and LNR >1/3 are more likely to develop progressive disease. The long-term OS rates of MTC are good, but long-term DFS rates are poor.
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