Multivariate analysis of prognostic factors in sporadic medullary carcinoma of the thyroid: A retrospective study of 109 consecutive patients

Scopsi, Lucio; Sampietro, Giuseppe; Boracchi, Patrizia; Bo, Romualdo Del; Gullo, Maria; Placucci, Marco; Pilotti, Silvana

doi:10.1002/(sici)1097-0142(19961115)78:10<2173::aid-cncr20>3.3.co;2-d

Cited by 15 publications

(32 citation statements)

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“…Node status was identified as a prognostic factor in the univariate analysis in our study and in others (Schroder et al, 1988;van Heerden et al, 1990;Raue et al, 1993;Dottorini et al, 1996;Scopsi et al, 1996;Bergholm et al, 1997;Modigliani et al, 1998;Hyer et al, 2000;Kebebew et al, 2000a). In another study, with rising numbers of metastatic lymph node, gross distant metastases occurred more frequently and postoperative basal CT level was less often normalised (Machens et al, 2000).…”

Section: Discussionsupporting

confidence: 79%

“…In patients with elevated postoperative basal CT level, the 5-year relapse-free survival rate was 61%, similar to that reported by van Heerden et al (1990). The prognostic factors for survival of MTC patients include the age at diagnosis, the gender and the TNM classification (Schroder et al, 1988;Raue et al, 1993;Dottorini et al, 1996;Scopsi et al, 1996;Bergholm et al, 1997;Modigliani et al, 1998;Kebebew et al, 2000a). Data concerning MTC patients with normal postoperative imaging are few.…”

Section: Discussionsupporting

confidence: 72%

“…Tumour extension is, in our study and in others, a significant independent prognostic factor (Scopsi et al, 1996). In our study, in the group of patients with an elevated postoperative basal CT level, the risk of relapse was even higher when the tumour was pT4.…”

Section: Discussionsupporting

confidence: 69%

“…However, the 10-year overall survival rate varied widely among series, from 55 up to 100% respectively (Rougier et al, 1983;Saad et al, 1984;Schroder et al, 1988;Raue et al, 1993;Dottorini et al, 1996;Scopsi et al, 1996;Bergholm et al, 1997;Modigliani et al, 1998). As therapy should be adapted to the prognosis of the disease, the identification of patients at high risk of relapse is essential.…”

Section: Discussionmentioning

confidence: 99%

“…Five and 10-year overall survival rates in MTC patients without initial distant metastases range between 60 -100% and 55 -100%, respectively, suggesting that an aggressive therapeutic approach may not be appropriate in all patients (Rougier et al, 1983;Saad et al, 1984;Schroder et al, 1988;Raue et al, 1993;Dottorini et al, 1996;Scopsi et al, 1996;Bergholm et al, 1997;Modigliani et al, 1998). In patients with elevated plasma CT level and with no evidence of gross residual disease after initial surgery, the rate of clinical or imaging-detected relapses is about 40% during the subsequent follow-up (Rougier et al, 1983;Van Heerden et al, 1990).…”

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confidence: 99%

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Long-term outcome of medullary thyroid carcinoma in patients with normal postoperative medical imaging

et al. 2003

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Imaging-detected relapses are observed in a significant proportion of patients with medullary thyroid carcinoma (MTC) with normal postoperative imaging studies. The aim of this study was to search for prognostic factors of imaging-detected relapse. This retrospective study was performed in 63 consecutive MTC patients with normal postoperative medical imaging. After surgery, the basal calcitonin (CT) level was undetectable in 35 patients and elevated in 28. During follow-up, 18 patients developed a clinical or imaging-detected relapse (29%) in the neck and/or at distant sites: 15 had an elevated postoperative basal CT level and three had an undetectable postoperative basal CT level. At multivariate analysis, the significant parameters predictive of imaging-detected relapse were the postoperative plasma CT level and the tumour extension (pT). The 3-and 5-year relapse-free survival rates were 94 and 90% in patients with an undetectable postoperative basal CT level, and 78 and 61% in patients with a detectable basal CT level (Po0.05). The 3-and 5-year relapse-free survival rates were 92 and 85% in the pT1 -3 patients, and 57 and 46% in the pT4 patients (Po0.01). These results show that postoperative CT level and tumour extension are critical prognostic factors for the identification of patients at a high risk of relapse.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 72%

Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Long-term outcome of medullary thyroid carcinoma in patients with normal postoperative medical imaging

et al. 2003

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Angiography effectively supports the diagnosis of hepatic metastases in medullary thyroid carcinoma

Ésik¹,

Szavcsur²,

Szakáll³

et al. 2001

Cancer

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BACKGROUND Medullary thyroid carcinoma (MTC) belongs in the group of neuroendocrine tumors with early lymphatic and hepatic dissemination. A high rate of undetectable metastases is hypothesized to be responsible for the frequent mismatch between the apparent relatively small tumor burden and the elevated plasma tumor marker level. METHODS Thirty‐six MTC patients with residual/recurrent biochemical signs (elevated basal calcitonin level) and/or characteristic general symptoms (diarrhea and/or flushing) were systematically examined by conventional radiology, whole‐body 18F‐deoxyglucose positron emission tomography (PET), dynamic liver computed tomography and magnetic resonance imaging, and hepatic angiography. RESULTS Conventional diagnostic imaging revealed lymph node (LN) involvement in the cervical, mediastinal, supraclavicular, and axillary regions (16 cases), and multiple pulmonary (3 cases), bony (1 solitary and 1 multiple case), and breast (1 case) metastases. 18F‐deoxyglucose PET identified all these extralymphatic metastatic lesions (except 2 cases with multiple pulmonary metastases), and also supradiaphragmatic LN involvement in 34 (94%) patients. In 32 (89%) cases, multiple small (generally ≤ 1 cm) hypervascular, hepatic metastases undetectable by other imaging methods were localized angiographically. Of the 23 original pathologic specimens investigated, 18 (78%) exhibited LN involvement. The smallest primary tumor in patients with hepatic metastases was 1 cm. CONCLUSIONS Hepatic angiography is recommended for primary staging in MTC patients with a primary tumor measuring 1 cm or larger, and/or pathologically proven LN involvement, and also during restaging for suspected recurrences to avoid unnecessary extensive surgical LN dissection in the neck and mediastinum. Cancer 2001;91:2084–95. © 2001 American Cancer Society.

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Recurrent spinal metastasis of a sporadic medullary carcinoma of the thyroid after radiation therapy: a case report and review of the literature

Munoz-Bendix

Santacroce

Gierga

et al. 2015

Clinical Case Reports

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Multivariate analysis of prognostic factors in sporadic medullary carcinoma of the thyroid: A retrospective study of 109 consecutive patients

Cited by 15 publications

References 0 publications

Long-term outcome of medullary thyroid carcinoma in patients with normal postoperative medical imaging

Long-term outcome of medullary thyroid carcinoma in patients with normal postoperative medical imaging

Angiography effectively supports the diagnosis of hepatic metastases in medullary thyroid carcinoma

Recurrent spinal metastasis of a sporadic medullary carcinoma of the thyroid after radiation therapy: a case report and review of the literature

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