INTRODUCTION: Medullary thyroid carcinoma (MTC) is a neuroendocrine thyroid carcinoma with parafollicular C cell differentiation. It can occur in either sporadic or hereditary form. Surgery is still the only curative treatment. The efficacy of chemotherapy and radiotherapy is poor. METHODS: This was a retrospective study of 31 patients treated surgically for MTC in our oncology centre at Mansoura University between January 2008 and February 2019. RESULTS: The mean age at diagnosis was 39.9 years. The median pathological size was 4cm. Multifocal disease was found in 12 patients and extrathyroid extension in 3 cases. Twenty patients were pathologically node positive. The median number of positive lymph nodes was four. Seven cases were metastatic at diagnosis. Local recurrence occurred in six individuals while distant recurrence occurred only in one. The median time from surgery to local recurrence was 12 months. The estimated mean disease free survival was 56.5 months. Disease free survival was significantly related to age, metastasis and side of nodal spread. CONCLUSIONS: In our study cohort, the disease occurred predominantly in women and younger patients. Age, distant metastasis and nodal spread were the most significant prognostic factors. This study has also demonstrated that prognosis is not only affected by nodal involvement but also by side of involvement. The role of hemithyroidectomy in node negative unifocal disease with a small tumour size warrants further investigation.
INTRODUCTION: Medullary thyroid carcinoma (MTC) is a neuroendocrine thyroid carcinoma with parafollicular C cell differentiation. It can occur in either sporadic or hereditary form. Surgery is still the only curative treatment. The efficacy of chemotherapy and radiotherapy is poor. METHODS: This was a retrospective study of 31 patients treated surgically for MTC in our oncology centre at Mansoura University between January 2008 and February 2019. RESULTS: The mean age at diagnosis was 39.9 years. The median pathological size was 4cm. Multifocal disease was found in 12 patients and extrathyroid extension in 3 cases. Twenty patients were pathologically node positive. The median number of positive lymph nodes was four. Seven cases were metastatic at diagnosis. Local recurrence occurred in six individuals while distant recurrence occurred only in one. The median time from surgery to local recurrence was 12 months. The estimated mean disease free survival was 56.5 months. Disease free survival was significantly related to age, metastasis and side of nodal spread. CONCLUSIONS: In our study cohort, the disease occurred predominantly in women and younger patients. Age, distant metastasis and nodal spread were the most significant prognostic factors. This study has also demonstrated that prognosis is not only affected by nodal involvement but also by side of involvement. The role of hemithyroidectomy in node negative unifocal disease with a small tumour size warrants further investigation.
Entities:
Keywords:
Medullary carcinoma; Neck dissection; Recurrence; Survival; Thyroid cancer
Authors: Rossella Elisei; Martin J Schlumberger; Stefan P Müller; Patrick Schöffski; Marcia S Brose; Manisha H Shah; Lisa Licitra; Barbara Jarzab; Viktor Medvedev; Michael C Kreissl; Bruno Niederle; Ezra E W Cohen; Lori J Wirth; Haythem Ali; Colin Hessel; Yifah Yaron; Douglas Ball; Barry Nelkin; Steven I Sherman Journal: J Clin Oncol Date: 2013-09-03 Impact factor: 44.544
Authors: Dhakshinamoorthy Ganeshan; Erik Paulson; Cihan Duran; Maria E Cabanillas; Naifa L Busaidy; Chusilp Charnsangavej Journal: AJR Am J Roentgenol Date: 2013-12 Impact factor: 3.959