Medullary Thyroid Carcinoma: Prognosis of FamilialVersusSporadic Disease and the Role of Radiotherapy*

Abstract

A retrospective study of 202 patients with medullary thyroid carcinoma (MTC) diagnosed between 1943 and 1987 was done to compare the prognosis of patients with sporadic disease and those with the familial form of multiple endocrine neoplasia type II and to study the effect of radiotherapy. Patients with multiple endocrine neoplasia type II had a significantly higher survival rate than did patients with the sporadic variety (P less than 0.005), but most patients with sporadic tumors were older and had more advanced disease. No differences in survival rates were found when patients from these 2 groups were matched for age and involvement of the thyroid gland only (P greater than 0.3), involvement of the thyroid gland plus cervical nodes (P greater than 0.3), and involvement of the thyroid gland, cervical nodes, and soft tissue (P greater than 0.7). When patients with MTC who received radiotherapy were matched for age, extent of disease, and surgery with patients who had had no radiotherapy, the latter group was found to live significantly longer (P less than 0.05). We conclude that 1) the apparently poor prognosis of patients with the sporadic variety of MTC may be related to the patients' older age at detection rather than to inherent differences in the two forms of disease, and 2) radiotherapy has little effect on MTC.

Antisurvivin oligonucleotides inhibit growth and induce apoptosis in human medullary thyroid carcinoma cells

“…In MTC, objective responses to other forms of therapy such as chemotherapy and radiotherapy are mostly insufficent, fewer than 20% (Petursson, 1988;Samaan et al, 1988;Wu et al, 1994;Brierley et al, 1996;Vitale et al, 2001). Therefore MTC represents an attractive target for alternative gene therapeutic strategies, of which ASODNs may be considered as one of choices.…”

Treatment of medullary thyroid carcinoma: an update.

“…Samaan et al (1988) retrospectively studied 57 patients receiving 2500-6000 rads over 5 weeks. No improvement in overall survival rates was observed when patients treated with surgery alone or with a combination of surgery and radiation therapy were matched for age and for the involvement of cervical nodes, soft tissue and distant metastases.…”

“…The 10-year overall survival rate has been estimated at 75-76% for both US (Hundahl et al 1998) and German (Raue 1998) patients. MEN 2A patients generally have a better prognosis than those with sporadic MTC (Bergholm et al 1990); however, no differences in survival were seen when patients were 136 www.endocrinology.org matched for age and extent of disease (Samaan et al 1988). This suggests that patients with sporadic carcinoma are commonly diagnosed later, when the disease is more advanced.…”

“…This suggests that patients with sporadic carcinoma are commonly diagnosed later, when the disease is more advanced. As far as inherited MTC is concerned, FMTC seems to have the best survival rate, while MEN 2b has the worst (Grauer et al 1990, Samaan et al 1988, Nguyen et al 1992. Early diagnosis is essential in patients with MTC, in order to obtain the best cure rate.…”

Carcinoma medular da tireóide

“…A radioterapia pode ser indicada nos casos inoperáveis, podendo levar à redução da massa tumoral e ao alívio dos sintomas obstrutivos. Entretanto, complicações como traqueíte e fibrose cervical limitam seu uso (95,96).…”