Clinical Characteristics and Nomogram for Adult Medullary Thyroid Carcinoma

Abstract Objectives: The present study aimed to investigate the clinical characteristics and independent prognostic factors in adult patients with medullary thyroid carcinoma (MTC), followed by construction of nomogram-based prognostic prediction model for adult MTC.Methods: Relevant subjects were retrieved from Surveillance, Epidemiology, and End Results (SEER) program from January 1, 2004 through December 31, 2014. According to the multivariate analysis, the 3- and 5-year cancer-specific survival (CSS) in MTC patients was predicted by constructing a nomogram. Results: In total, 1279 patients diagnosed with primary MTC were extracted from the SEER database. The 3-, 5-and 10-year CSS rates were 91.11%, 88.32%, and 81.63%, respectively. The Cox proportional hazards model revealed that advanced AJCC stage and elderly age were independent unfavorable prognostic factors, and that surgery and radical lymph node dissection were protective prognostic factors (all P＜0.05). In addition, radiotherapy was independently related to the decreased survival. The C-index of nomogram was 0.902 (95% CI: 0.878–0.926) for the internal validations. Calibration plot revealed satisfactory agreement between the actual findings and predicted outcomes.Conclusion: The nomogram could individually and precisely predict the CSS of MTC patients, which could be used to facilitate in individualized prognostic assessment evaluation and clinical decision-making.

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Long-Term Outcomes and Causes of Death among Medullary Thyroid Carcinoma Patients with Distant Metastases

Cancers ◽

10.3390/cancers13184670 ◽

2021 ◽

Vol 13 (18) ◽

pp. 4670

Author(s):

Hyunju Park ◽

Heera Yang ◽

Jung Heo ◽

Tae Hyuk Kim ◽

Sun Wook Kim ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Medullary Thyroid Carcinoma ◽

Distant Metastasis ◽

Clinical Characteristics ◽

Causes Of Death ◽

Hazard Ratio ◽

Poor Prognostic Factor ◽

Medullary Thyroid ◽

Metastatic Site

Distant metastasis is a poor prognostic factor in medullary thyroid carcinoma (MTC), but the significance of differentiating the characteristics according to the site of distant metastasis remains unclear. This study aimed to evaluate the clinical characteristics and long-term oncologic outcomes in MTC patients with distant metastasis. We identified 46 MTC patients with distant metastasis between 1994 and 2019. Clinical characteristics were compared based on the timing of the detection of distant metastasis. Additionally, survival rates following the detection of distant metastasis were evaluated to compare the clinical significance of metastatic site. The detailed causes of death were also investigated. Of the 46 patients, 15 patients (32.6%) had synchronous distant metastasis and 31 patients (67.4%) had metachronous distant metastasis. There was no clinical difference between these two groups except regarding initial surgical extent. The lung (52.2%) was the most common metastatic site, followed by the bone (28.3%), mediastinum (19.6%), liver (17.4%), adrenal gland (4.3%), brain (4.3%), kidney (2.2%), and pancreas (2.2%). Patients with bone metastasis and multisite metastasis had significantly worse prognoses than those with lung metastasis (hazard ratio: 5.42; p = 0.044 and hazard ratio: 6.11; p = 0.006). Complications due to the progression of distant metastasis, airway obstruction due to tracheal invasion, and complications related to chemotherapy were leading causes of death. In conclusion, there was no difference in clinical characteristics according to the timing of distant metastasis. Oncological outcomes differed by metastatic site.

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