CONTEXT: In the management of patients with medullary thyroid carcinoma (MTC), calcitonin doubling time (dt) has gained interest as an independent predictor of recurrence and survival. OBJECTIVE: To perform a structured meta-analysis of the diagnostic value of calcitonin dt, carcinoembryonic antigen (CEA) dt and the combination and to define dt strata with the highest predictive power. Design The study was a meta-analysis using individual data. METHODS: Ten studies containing data on the post-operative kinetics of tumour marker(s) and (recurrence free) survival were included. RESULTS: Calcitonin- and CEA-dt are significant indicators for survival (hazard ratios (HR) 21.52 respectively infinite for dt 0-1 year compared to dt >1 year) and recurrence (HR 5.33 respectively 6.80 for dt 0-1 year compared to dt >1 year). The highest predictive power was found for the dt classification 0-1 year vs. >1 year. CEA dt has a higher predictive value than calcitonin dt in the subgroup of patients for which both parameters were available. CONCLUSION: The dts of both calcitonin and CEA are strong prognostic indicators for MTC recurrence and death. CEA dt has a higher predictive value than calcitonin dt and therefore measuring both tumour markers is essential for proper risk stratification.
CONTEXT: In the management of patients with medullary thyroid carcinoma (MTC), calcitonin doubling time (dt) has gained interest as an independent predictor of recurrence and survival. OBJECTIVE: To perform a structured meta-analysis of the diagnostic value of calcitonindt, carcinoembryonic antigen (CEA) dt and the combination and to define dt strata with the highest predictive power. Design The study was a meta-analysis using individual data. METHODS: Ten studies containing data on the post-operative kinetics of tumour marker(s) and (recurrence free) survival were included. RESULTS:Calcitonin- and CEA-dt are significant indicators for survival (hazard ratios (HR) 21.52 respectively infinite for dt 0-1 year compared to dt >1 year) and recurrence (HR 5.33 respectively 6.80 for dt 0-1 year compared to dt >1 year). The highest predictive power was found for the dt classification 0-1 year vs. >1 year. CEAdt has a higher predictive value than calcitonindt in the subgroup of patients for which both parameters were available. CONCLUSION: The dts of both calcitonin and CEA are strong prognostic indicators for MTC recurrence and death. CEAdt has a higher predictive value than calcitonindt and therefore measuring both tumour markers is essential for proper risk stratification.
Authors: Allen S Ho; Lu Wang; Frank L Palmer; Changhong Yu; Arnbjorn Toset; Snehal Patel; Michael W Kattan; R Michael Tuttle; Ian Ganly Journal: Ann Surg Oncol Date: 2014-11-04 Impact factor: 5.344
Authors: Gilbert J Cote; Caitlin Evers; Mimi I Hu; Elizabeth G Grubbs; Michelle D Williams; Tao Hai; Dzifa Y Duose; Michal R Houston; Jacquelin H Bui; Meenakshi Mehrotra; Steven G Waguespack; Naifa L Busaidy; Maria E Cabanillas; Mouhammed Amir Habra; Rajyalakshmi Luthra; Steven I Sherman Journal: J Clin Endocrinol Metab Date: 2017-09-01 Impact factor: 5.958
Authors: Cléber P Camacho; Susan C Lindsey; Maria Clara C Melo; Ji H Yang; Fausto Germano-Neto; Flávia de O F Valente; Thiago R N Lima; Rosa Paula M Biscolla; José G H Vieira; Janete M Cerutti; Magnus R Dias-da-Silva; Rui M B Maciel Journal: Thyroid Date: 2013-03 Impact factor: 6.568
Authors: Tomasz Gawlik; Andrea d'Amico; Sylwia Szpak-Ulczok; Aleksander Skoczylas; Elżbieta Gubała; Anna Chorąży; Kamil Gorczewski; Jan Włoch; Barbara Jarząb Journal: Thyroid Res Date: 2010-11-03