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Dynamic risk stratification in medullary thyroid carcinoma: Single institution experiences

Authors
 Jung Bum Choi  ;  Seul Gi Lee  ;  Min Jhi Kim  ;  Tae Hyung Kim  ;  Eun Jeong Ban  ;  Cho Rok Lee  ;  Jandee Lee  ;  Sang-Wook Kang  ;  Jong Ju Jeong  ;  Kee-Hyun Nam  ;  Woong Youn Chung 
Citation
 Medicine, Vol.97(3) : e9686, 2018 
Journal Title
 Medicine 
ISSN
 0025-7974 
Issue Date
2018
MeSH
Carcinoma, Neuroendocrine/pathology ; Carcinoma, Neuroendocrine/therapy* ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Risk Assessment ; Thyroid Neoplasms/pathology ; Thyroid Neoplasms/therapy* ; Treatment Outcome
Abstract
Recently, dynamic risk stratification has been found to be more valuable than static anatomic staging system in nonmedullary thyroid cancer and this strategy has also been accepted in medullary thyroid cancer (MTC). The present study was designed to compare the clinical usefulness of response to initial therapy stratification with a traditional anatomic staging system.From August 1982 to December 2012, a total of 144 MTC patients underwent thyroidectomy in Yonsei University Hospital. Among them, 117 (82.2%) patients with complete clinical data and sustained follow-up were enrolled in this study. Clinicopathological features and surgical outcomes were analyzed by retrospective medical chart review. Mean follow-up duration was 85.78 ± 62.51 months.In this study, mean tumor size was 1.94 ± 1.40 cm and 22 (18.9%) patients had hereditary MTC; 95 (81.1%) patients had sporadic MTC. Stage I patients had highest probability of excellent response to initial therapy (92.1%). Stage IV patients had highest probability of biochemical and structural incomplete response to initial therapy (57.5% and 30.3%) and lowest probability of excellent response to initial therapy (12.1%). Both response to initial therapy stratification and TNM staging system offered useful prognostic information in this study. The TNM staging system provided risk stratification pertaining to disease-free survival (DFS), disease-specific survival (DSS), and the probability of having no evidence of disease at final outcome, but did not provide risk stratification pertaining to the probability of having biochemical persistent/recurrence disease at final outcome. However, response to initial therapy stratification provided risk stratification pertaining to not only DFS, DSS, and the probability of having no evidence of disease at final outcome but also the probability of having biochemical persistent/recurrence disease at final outcome.In this study, we demonstrated that dynamic risk stratification with adjusted response to initial therapy system can offer more useful prognostic information than anatomic staging system in MTC.
Files in This Item:
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DOI
10.1097/MD.0000000000009686
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
강상욱(Kang, Sang Wook) ORCID logo https://orcid.org/0000-0001-5355-833X
남기현(Nam, Kee Hyun) ORCID logo https://orcid.org/0000-0002-6852-1190
반은정(Ban, Eun Jeong)
이슬기(Lee, Seul Gi)
이잔디(Lee, Jan Dee) ORCID logo https://orcid.org/0000-0003-4090-0049
이초록(Lee, Cho Rok)
정웅윤(Chung, Woung Youn)
정종주(Jeong, Jong Ju) ORCID logo https://orcid.org/0000-0002-4155-6035
최정범(Choi, Jung Bum)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/166853
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