Medullary thyroid carcinoma: Search for histological predictors of survival (109 proband cases analysis)

Franc, Brigitte; Rosenberg-Bourgin, Myriam; Caillou, Bernard; Dutrieux-Berger, N; Floquet, J; Houcke-Lecomte, M; Justrabo, E; Lange, Françoise; Labat-Moleur, F; Bodic, Marie-Françoise Le; Patey, Martine; Beauchet, Alain; Saint‐André, Jean‐Paul; Hejblum, Gilles; Viennet, G.

doi:10.1016/s0046-8177(98)90417-8

Cited by 53 publications

(26 citation statements)

References 23 publications

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“…This observation is contrary to other studies,1,6,14,15,18,22,28,30,31,33,34,35 which have stated that older patients generally had worse prognoses than younger ones. Statistical significance was also not obtained when sex was compared to clinical progression, as observed by other authors 22,27.…”

Section: Discussioncontrasting

confidence: 95%

Prognostic Influence of Clinical and Pathological Factors in Medullary Thyroid Carcinoma: A Study of 53 Cases

Brandão

Cavalheiro

Junqueira

2009

Clinics

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OBJECTIVES AND INTRODUCTIONMedullary thyroid carcinoma, a neoplasia of intermediate prognosis and differentiation, does not always respond predictably to known treatments. This study aimed to correlate the clinical progression of surgically treated patients with clinical and pathological data.METHODSA total of 53 patients were followed for 75 months (mean average) in tertiary-care hospital. The clinical status of patients at the end of the study period was characterized to determine correlations with a range of disease aspects. A value of p < 0.05 was considered statistically significant.RESULTSTwenty-two patients (41.5%) were alive and disease-free at the end of the follow-up period; twenty-three patients (43.4%) had persistent disease; and eight patients (15.1%) had recurrent disease. Four patients (7.6%) died from medullary thyroid carcinoma with clinical and/or imaging evidence of neoplasia. The following aspects demonstrated statistically significant correlations with the final medical condition: positive initial cervical examination (p = 0.002); neoplastic extensions to the thyroid capsule (p = 0.004) and adjacent tissues (p = 0.034); cervical lymph node metastases (p < 0.001); diameter of neoplasia (p = 0.018); TNM (tumor, node and metastasis) Stage (p = 0.001) and evidence of distant and/or cervical diseases in the absence of a cure (p = 0.011). Through logistic regression, the presence of cervical lymph node metastases was considered an independent variable (p < 0.001).CONCLUSIONSClinical and pathological aspects of patients with surgically treated medullary thyroid carcinomas are predictors of disease progression. Specifically, even treated cervical lymph node metastases are significantly correlated with disease progression.

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Section: Discussioncontrasting

confidence: 95%

Prognostic Influence of Clinical and Pathological Factors in Medullary Thyroid Carcinoma: A Study of 53 Cases

Brandão

Cavalheiro

Junqueira

2009

Clinics

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Section: Discussionmentioning

confidence: 99%

“…The prognostic value of calcitonin immunostaining has been studied in primary [4, 17, 18] and metastatic tumors [4, 16]. These studies concluded that calcitonin-poor primary tumors were associated with lower survival rates [4, 17, 18]. The same was also true for calcitonin-poor metastases [4, 17], which had an aggressive clinical course and poor prognosis [4, 19].…”

Section: Discussionmentioning

confidence: 99%

Medullary Thyroid Carcinoma with Micronodular Lung Metastases: A Case Report with an Emphasis on the Imaging Findings

Ventura

Marchiori

Zanetti

et al. 2010

Case Reports in Medicine

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Medullary thyroid carcinoma is a rare malignancy that arises from calcitonin-producing C-cells and frequently metastasizes to lymph nodes in the neck. Distant metastases may involve bone, lung, and liver. The infrequent number of cases limits the clinical nature and ability to optimize diagnostic tools. Here, we present a case of a micronodular radiographic pattern in metastatic medullary thyroid cancer in order to enhance awareness of the disease process. A case discussion and relevant review of the literature are provided.

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“…42 The patterns of calcitonin immunoreactivity may be prognostically significant. 43,44 In univariate analyses, survival of patients with tumors containing less than 50% of calcitonin-immunoreac- tive cells was poorer than in those patients whose tumors contained more than 50% calcitonin-immunoreactive cells.…”

Section: Medullary Thyroid Carcinomamentioning

confidence: 99%

“…Several studies have suggested that such tumors may have a particularly aggressive course. 44,56 Immunoreactivity for bcl-2 has been demonstrated in almost 80% of MTCs. Lack of bcl-2 may correlate with shorter survival times than those tumors that are bcl-2 positive.…”

Section: Medullary Thyroid Carcinomamentioning

confidence: 99%

Medullary Thyroid Carcinoma

DeLellis¹

2006

Pathology Case Reviews

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Medullary thyroid carcinomas (MTCs) are currently defined as malignant tumors with evidence of C-cell differentiation. They comprise 5%-10% of all thyroid malignancies and occur sporadically (75%) or as a manifestation of the type 2 multiple endocrine neoplasia syndromes (25%). Results of calcitonin screening in patients with nodules thyroid disease have revealed a mean prevalence of tumors of 0.61% (range, 0.24% to 2.85%), most of which represent microscopic or incidental MTCs measuring less than 1 cm. While heritable and sporadic tumors contain amyloid and have a lobular to solid growth pattern and polyhedral-to spindleshaped cells, numerous variants of these tumors also occur. C-cell hyperplasia (CCH) has been regarded as the precursor of heritable MTCs, although recent studies suggest that CCH is a clonal process and should be considered a form of intraepithelial C-cell neoplasia. Activating germline mutations of RET, primarily affecting exons 10 and 11, with less frequent involvement of exons 13, 14, 15, and 16, represent the molecular basis for the development of heritable MTCs. Somatic RET mutations, primarily affecting codon 918, occur in a substantial proportion of sporadic MTCs. Five-year and 10-year survivals for sporadic MTCs are 65% and 50%, respectively, with major risk factors for unfavorable outcome including tumor stage, male sex, and age greater than 60 years. With the development of molecular testing for RET mutations, the prognosis for patients with heritable MTCs is generally excellent.

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Medullary thyroid carcinoma: Search for histological predictors of survival (109 proband cases analysis)

Cited by 53 publications

References 23 publications

Prognostic Influence of Clinical and Pathological Factors in Medullary Thyroid Carcinoma: A Study of 53 Cases

Prognostic Influence of Clinical and Pathological Factors in Medullary Thyroid Carcinoma: A Study of 53 Cases

Medullary Thyroid Carcinoma with Micronodular Lung Metastases: A Case Report with an Emphasis on the Imaging Findings

Medullary Thyroid Carcinoma

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