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Postoperative biochemical remission of serum calcitonin is the best predictive factor for recurrence-free survival of medullary thyroid cancer: a large-scale retrospective analysis over 30 years

Authors
 Kyong Yeun Jung  ;  Seok-Mo Kim  ;  Won Sang Yoo  ;  Bup-Woo Kim  ;  Yong Sang Lee  ;  Kyung Won Kim  ;  Kyu Eun Lee  ;  Jong Ju Jeong  ;  Kee-Hyun Nam  ;  Se Hoon Lee  ;  Jeong Hun Hah  ;  Woong Youn Chung  ;  Ka Hee Yi  ;  Do Joon Park  ;  Yeo-Kyu Youn  ;  Myung-Whun Sung  ;  Bo Youn Cho  ;  Cheong Soo Park  ;  Young Joo Park  ;  Hang-Seok Chang 
Citation
 CLINICAL ENDOCRINOLOGY, Vol.84(4) : 587-597, 2016 
Journal Title
 CLINICAL ENDOCRINOLOGY 
ISSN
 0300-0664 
Issue Date
2016
MeSH
Adult ; Aged ; Calcitonin/blood* ; Carcinoma, Neuroendocrine/blood* ; Carcinoma, Neuroendocrine/pathology ; Carcinoma, Neuroendocrine/surgery* ; Disease-Free Survival ; Female ; Humans ; Kaplan-Meier Estimate ; Logistic Models ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Outcome Assessment (Health Care)/methods ; Outcome Assessment (Health Care)/statistics & numerical data ; Postoperative Period ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Remission Induction ; Retrospective Studies ; Risk Factors ; Sex Factors ; Thyroid Neoplasms/blood* ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/surgery* ; Tumor Burden
Abstract
CONTEXT: The increase in thyroid screening in the general population may lead to earlier detection of medullary thyroid carcinoma (MTC). OBJECTIVE: We aimed to evaluate secular trends in clinicopathological characteristics and long-term prognosis of MTC and its prognostic factors. DESIGN: This was a retrospective analysis from 1982 to 2012. PATIENTS: Three hundred and thirty-one patients with MTC were included and grouped based on the year of diagnosis (1982-2000, 2001-2005, 2006-2010 and 2011-2012). MEASUREMENTS: These included recurrence and mortality as well as biochemical remission (BCR) of serum calcitonin. RESULTS: Mean tumour size (from 2·5 cm to 1·7 cm, P < 0·001) and percentage of extrathyroidal extension (from 52·0% to 26·0%, P = 0·026) decreased. The percentage of patients achieving BCR within six postoperative months (po-BCR) increased with time (from 39·6% to 76·1%, P < 0·001). The 5-year overall recurrence rate significantly decreased in 2006-2012 compared to 1982-2005 (10% vs 18%, respectively, P = 0·031), although the 5-year survival rate did not improve (92% vs 92%, P = 0·929). Failure to achieve po-BCR was the strongest predictive factor associated with recurrence (hazard ratio [HR] = 58·04, 95% CI 7·14-472·11; P < 0·001). Male gender (HR = 3·18, 95% CI 1·18-8·56; P = 0·022), tumour size >2 cm (HR = 18·33, 95% CI 2·35-143·06; P = 0·006) and distant metastasis (HR = 4·00, 95% CI 1·31-12·21; P = 0·015) were significant prognostic factors for mortality. CONCLUSIONS: Clinicopathological characteristics and recurrence of MTC improved with time. Po-BCR was the best predictive factor for recurrence-free survival.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/cen.12852/abstract
DOI
10.1111/cen.12852
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Bup Woo(김법우) ORCID logo https://orcid.org/0000-0002-1342-9055
Kim, Seok Mo(김석모) ORCID logo https://orcid.org/0000-0001-8070-0573
Nam, Kee Hyun(남기현) ORCID logo https://orcid.org/0000-0002-6852-1190
Park, Cheong Soo(박정수)
Lee, Yong Sang(이용상) ORCID logo https://orcid.org/0000-0002-8234-8718
Chang, Hang Seok(장항석) ORCID logo https://orcid.org/0000-0002-5162-103X
Chung, Woong Youn(정웅윤)
Jeong, Jong Ju(정종주) ORCID logo https://orcid.org/0000-0002-4155-6035
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/146524
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