Risk Factors Associated With Reoperation and Disease-Specific Mortality in Patients With Medullary Thyroid Carcinoma

Kuo, Eric J.; Sho, Shonan; Li, Ning; Zanocco, Kyle; Yeh, Michael W.; Livhits, Masha J.

doi:10.1001/jamasurg.2017.3555

Cited by 69 publications

(61 citation statements)

References 23 publications

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“…Oncologic outcomes may be influenced by immediate reoperations in patients who initially had less than recommended operations, but patients with sporadic disease that get a routine reoperation where no disease is actually recovered incur operative risks without any oncologic benefit. Interestingly, in a recent study by Kuo et al reoperation for MTC did not change 5‐year DSS …”

Section: Discussionmentioning

confidence: 84%

Survival in patients with medullary thyroid cancer after less than the recommended initial operation

Randle

Bates

Sippel

et al. 2017

Journal of Surgical Oncology

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Section: Discussionmentioning

confidence: 84%

Survival in patients with medullary thyroid cancer after less than the recommended initial operation

Randle

Bates

Sippel

et al. 2017

Journal of Surgical Oncology

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“…Adjuvant therapy in general is of limited value [ 3 – 5 ]. Unfortunately, in more than 50% of patients, calcitonin levels remain elevated after supposed curative resection, indicating that subclinical active tumour tissue is still present [ 3 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

SSTR2A expression in medullary thyroid carcinoma is correlated with longer survival

et al. 2018

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PurposeMedullary thyroid carcinoma (MTC) derives from the parafollicular C-cells of the thyroid gland. Somatostatin receptors (SSTRs) are expressed in various neuroendocrine tumours including MTC. The aim of this study was to evaluate SSTR2A as a prognostic factor for MTC, to study distribution of SSTR2A expression within tumours and to compare expression of SSTR2A between primary tumours and corresponding lymph node metastases.MethodsPatients who underwent surgery between 1988 and 2014 for MTC from five tertiary referral centres in The Netherlands were included. In total, primary tumours of 114 patients and lymph node metastases of 34 patients were analysed for expression of SSTR2A using a tissue microarray, and correlated with clinicopathological variables and survival.ResultsThe mean age of patients was 45.5 years (SD 16.2), 55 patients were male (49.5%). Primary tumours of 58 patients (50.9%) showed SSTR2A expression. In multivariate Cox-regression analysis, SSTR2A positivity correlated independently with better overall survival (OS) (HR 0.3; 95% CI 0.1–1.0). In stage IV MTC patients, 10-year survival rates for SSTR2A-negative and positive patients were 43% and 96%, respectively. In 53.9% of patients with lymph node metastases, expression in primary tumour and lymph node metastases differed.ConclusionSSTR2A expression is correlated with longer OS in MTC, especially for stage IV patients, suggesting that SSTR2A expression might be a useful prognostic factor in MTC. The SSTR2A status of the primary MTC does not predict expression in lymph node metastases.

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“…Patients with MTC with an obvious thyroid nodule frequently present with cervical metastases and ~13% present with distant metastases ( 4 , 5 ). The 10-year MTC-specific mortality rate ranges from 13.5–38% worldwide ( 6 ). The clinical stage at the time of diagnosis and the probability of complete surgical removal of the tumor are the two most important determinants for the successful treatment of MTC ( 7 ).…”

Section: Introductionmentioning

confidence: 99%

miR‑592 acts as an oncogene and promotes medullary thyroid cancer tumorigenesis by targeting cyclin‑dependent kinase 8

2020

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Medullary thyroid carcinoma (MTC) is a relatively rare subtype of thyroid cancer, accounting for 5–10% of all cases of thyroid cancer worldwide. Due to the current lack of knowledge regarding the tumorigenesis of MTC, the clinical treatment of MTC remains a challenge. It has been reported that microRNAs (miRNAs) regulate the progression of MTC; however, the regulatory network of miRNAs and the exact underlying mechanisms are not completely understood. In the present study, an miRNA expression profile (GSE40807), consisting of 80 samples, was downloaded and analyzed using Gene Expression Omnibus-2R to identify differentially expressed miRNAs between MTC and normal samples. miR-592 expression levels were significantly increased in MTC tissues and cell lines compared with normal tissues and cell lines. Patients with high miR-592 expression levels exhibited a less favorable prognosis compared with patients with low miR-592 expression. The results suggested that miR-592 overexpression promoted TT and MZ-CRC-1 cell proliferation in vitro . In addition, miR-592 negatively regulated cyclin-dependent kinase 8 (CDK8) via targeted binding in MTC cells. Moreover, co-transfection of CDK8 overexpression plasmid and miR-592 mimic reversed miR-592-mediated MTC cell proliferation. In conclusion, miR-592 may serve as an oncogene in MTC by decreasing the expression of CDK8, indicating that the miR-592/CDK8 axis might serve as a promising therapeutic target for MTC.

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Risk Factors Associated With Reoperation and Disease-Specific Mortality in Patients With Medullary Thyroid Carcinoma

Abstract: Lymph node dissection may decrease recurrence leading to reoperation for patients with MTC. Reoperation is a viable strategy to achieve long-term disease-free survival in appropriately selected patients. Central neck dissection remains underused.

Cited by 69 publications

References 23 publications

Survival in patients with medullary thyroid cancer after less than the recommended initial operation

Survival in patients with medullary thyroid cancer after less than the recommended initial operation

SSTR2A expression in medullary thyroid carcinoma is correlated with longer survival

miR‑592 acts as an oncogene and promotes medullary thyroid cancer tumorigenesis by targeting cyclin‑dependent kinase 8

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