Aggressive medullary thyroid cancer, an analysis of the Irish National Cancer Registry

Lennon, Paul; Deady, Sandra; White, Nick; Lambert, Deborah; Healy, M. J. R.; Green, Andrew J.; Kinsella, John; Timon, Conrad; Neill, Jennifer

doi:10.1007/s11845-016-1455-1

Cited by 10 publications

(11 citation statements)

References 45 publications

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“…In the nationwide period, the female-to-male ratio for all MTC was 1.43. This is in accordance with the ratio found in other epidemiologic studies on the subject ( 8 , 35 , 36 , 37 , 38 ). As for virtually all sporadic thyroid cancers, this sex disparity still remains unexplained ( 39 ).…”

Section: Discussionsupporting

confidence: 93%

“…As for virtually all sporadic thyroid cancers, this sex disparity still remains unexplained ( 39 ). The mean age at diagnosis of 52.4 years for all MTC patients was also comparable to that of other population-based series ( 8 , 37 ). If only considering patients diagnosed at autopsy, female-to-male ratio and age at diagnosis were identical to other series ( 40 ).…”

Section: Discussionsupporting

confidence: 83%

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Incidence and prevalence of sporadic and hereditary MTC in Denmark 1960–2014: a nationwide study

Mathiesen

Kroustrup

Vestergaard

et al. 2018

Endocrine Connections

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Recent studies have shown a significant increase in the temporal trend of medullary thyroid carcinoma (MTC) incidence. However, it remains unknown to which extent sporadic medullary thyroid carcinoma (SMTC) and hereditary MTC (HMTC) affect the MTC incidence over time. We conducted a nationwide retrospective study using previously described RET and MTC cohorts combined with review of medical records, pedigree comparison and relevant nationwide registries. The study included 474 MTC patients diagnosed in Denmark between 1960 and 2014. In the nationwide period from 1997 to 2014, we recorded a mean age-standardized incidence of all MTC, SMTC and HMTC of 0.19, 0.13 and 0.06 per 100,000 per year, respectively. The average annual percentage change in incidence for all MTC, SMTC and HMTC were 1.0 (P = 0.542), 2.8 (P = 0.125) and −3.1 (P = 0.324), respectively. The corresponding figures for point prevalence at January 1, 2015 were 3.8, 2.5 and 1.3 per 100,000, respectively. The average annual percentage change in prevalence from 1998 to 2015 for all MTC, SMTC and HMTC was 2.8 (P < 0.001), 3.8 (P < 0.001) and 1.5 (P = 0.010), respectively. We found no significant change in the incidence of all MTC, SMTC and HMTC possibly due to our small sample size. However, due to an increasing trend in the incidence of all MTC and opposing trends of SMTC (increasing) and HMTC (decreasing) incidence, it seems plausible that an increase for all MTC seen by others may be driven by the SMTC group rather than the HMTC group.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 83%

Incidence and prevalence of sporadic and hereditary MTC in Denmark 1960–2014: a nationwide study

Mathiesen

Kroustrup

Vestergaard

et al. 2018

Endocrine Connections

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“…However, a large portion of MTC cases are not identified until post‐surgical histology is performed, with a corollary that presently, the uninformed initial surgical approach may thus be incomplete in the extent of thyroid or nodal surgery in many MTC patients 1,5 . Current guidelines suggest all patients with MTC should receive a total thyroidectomy and central neck dissection but recent literature suggests that up to 40% of patients with MTC do not receive central neck dissection at first surgery 13,20 . The failure of preoperative cytologic diagnosis in MTC may be one of several factors that underlies this poor compliance with MTC guidelines.…”

Section: Discussionmentioning

confidence: 99%

Limitations of preoperative cytology for medullary thyroid cancer: Proposal for improved preoperative diagnosis for optimal initial medullary thyroid carcinoma specific surgery

et al. 2020

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Background Preoperative diagnosis of medullary thyroid carcinoma (MTC) is often difficult, given the poor sensitivity of fine‐needle aspiration (FNA) cytology for MTC. This study investigates this issue and presents recommendations for improving preoperative diagnostic paradigms in MTC cases. Design/Method Histopathologically confirmed MTC patients with preoperative cytologic assessment of index nodules were enrolled. FNA diagnosis, final pathology, and surgery details were collected. Results Out of 71 patients, 49 (69%) were diagnosed by FNA as either definitive MTC (35, 49%) or suspected MTC (14, 20%) and 22 (31%) patients had no indication of MTC on FNA. Conclusion In a tertiary‐care setting, one‐third of subjects had an FNA interpretation that did not suggest the possibility of MTC. The limitations of preoperative diagnosis are especially problematic for MTC as they can cause delayed or incomplete treatment. Additional testing is proposed to improve preoperative diagnosis and surgical care of MTC patients.

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“…Slovenian population increased by approximately 3.6% annually, which represents a significant increase. The crude annual incidence rate in the Slovenian population is approximately three times higher than that reported in Ireland (0.11/100,000) and higher than that reported in Denmark (0.28/100,000) (8,17). The difference could be attributed to a different incidence of thyroid malignancies in general and different age distribution in the population.…”

Section: Discussionmentioning

confidence: 58%

“…To our knowledge, six population-based analyses have been published so far (7)(8)(9)(10)17,22). A Norwegian study (10) described all known RET-positive MEN 2A patients with MTC from four centers.…”

Section: Discussionmentioning

confidence: 99%

Crude annual incidence rate of medullary thyroid cancer and RET mutation frequency

Milicevic¹,

Bergant²,

Žagar³

et al. 2021

Croat Med J

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Aim To determine the frequency and type of RET mutation in Slovenian medullary thyroid cancer (MTC) patients and estimate the crude annual incidence of MTC in Slovenia.Methods This referral-center retrospective analysis involved 186 MTC patients diagnosed between 1995 and 2015 and their relatives who underwent genetic counseling and testing. The crude incidence rate of MTC was estimated with the joinpoint regression analysis. Genomic DNA was isolated, and exons 10, 11, 13, 14, 15, and 16 of the RET proto-oncogene were amplified with polymerase chain reaction. Point mutations of the RET gene were detected by single-strand conformation analysis and DNA sequencing. Detected mutations were confirmed by restriction enzymes. ResultsThe average crude annual incidence rate of MTC in Slovenia was 0.34/100,000. A germline mutation in the RET proto-oncogene was identified in 25.9% of MTC patients. The most frequently altered codons were codons 634 and 618, followed by codon 790, codon 804, and codon 918. ConclusionsAnnual incidence increase and nation-specific frequency of RET mutations justify the future use of genetic counseling and testing of MTC patients in Slovenia.

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Aggressive medullary thyroid cancer, an analysis of the Irish National Cancer Registry

Abstract: Our patient cohort was substantially older and presented at an advanced T status than what is commonly seen in the literature. This may account for poor survival outcomes and the very low pick-up of RET mutations in sporadic medullary thyroid cancer.

Cited by 10 publications

References 45 publications

Incidence and prevalence of sporadic and hereditary MTC in Denmark 1960–2014: a nationwide study

Incidence and prevalence of sporadic and hereditary MTC in Denmark 1960–2014: a nationwide study

Limitations of preoperative cytology for medullary thyroid cancer: Proposal for improved preoperative diagnosis for optimal initial medullary thyroid carcinoma specific surgery

Crude annual incidence rate of medullary thyroid cancer and RET mutation frequency

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