Medullary thyroid carcinoma: the influence of policy changing in clinical characteristics and disease progression

Alevizaki, Maria; Saltiki, Katerina; Rentziou, Gianna; Papathoma, Alexandra; Sarika, Leda; Vasileiou, Vasiliki; Anastasiou, Eleni

doi:10.1530/eje-12-0388

Cited by 20 publications

(20 citation statements)

References 48 publications

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“…In recent years, the incidence of small thyroid cancer has increased globally mainly as a result of thyroid ultrasound screening . Consistent with this, changes over time in clinicopathological characteristics, outcomes and prognostic factors for differentiated thyroid cancer (DTC) have been reported. In a similar manner, increases in thyroid screening with ultrasound and measurement of serum calcitonin in subjects with thyroid nodules might have led to earlier detection of smaller MTCs.…”

Section: Introductionmentioning

confidence: 69%

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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

Jung

Kim

Yoo

et al. 2015

Clinical Endocrinology

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Section: Introductionmentioning

confidence: 69%

“…Therefore, the clinicopathological characteristics and prognosis of MTC might also change over time. However, the reported prognosis or predictive factors for MTC were mainly based on patients diagnosed before early 2000, and changes in clinicopathological features or prognosis over time have been rarely reported …”

Section: Introductionmentioning

confidence: 99%

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

Jung

Kim

Yoo

et al. 2015

Clinical Endocrinology

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“…In this retrospective study of MTC patients, we aimed to investigate whether tumour size could be of prognostic value for the clinical behaviour of MTCs, especially of smallMTCs (%1.5 cm); the aggressiveness of larger tumours has previously been shown (1,13,16,19,20). We divided smallMTCs into four size subgroups roughly representing quartiles and compared the clinical features between subgroups.…”

Section: Discussionmentioning

confidence: 99%

Small medullary thyroid carcinoma: post-operative calcitonin rather than tumour size predicts disease persistence and progression

Saltiki

Rentziou

Stamatelopoulos

et al. 2014

European Journal of Endocrinology

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Objective: Recently, small medullary thyroid carcinomas (smallMTCs; %1.5 cm) are frequently diagnosed, occasionally as incidental findings in surgical specimens. Their clinical course varies. We examined tumour size as a predictor of clinical behaviour. Design: A retrospective study. Methods: A total of 128 smallMTC patients (35.2% males and 45% familial) were followed up for 0.9-30.9 years. According to tumour size (cm), patients were classified into four groups: group 1, 0.1-0.5 (nZ33); group 2, 0.6-0.8 (nZ33); group 3, 0.8-1.0 (nZ29) and group 4, 1.1-1.5 (nZ33). Results: Pre-and post-operative calcitonin levels were positively associated with the tumour size (P!0.001). Capsular and lymph node invasion were more frequent in groups 3 and 4 (P!0.03); the stage was more advanced and the outcome was less favourable with an increasing tumour size (P!0.001). Groups 1 and 2 patients were more frequently cured (group 1, 87.8%; group 2, 72.7%; group 3, 68.9%; and group 4, 48.5%; PZ0.002). The 10-year probability of lack of disease progression according to the tumour size differed between patients with tumour sizes of 0.1-1.0 and 1.1-1.5 cm (96.6%, 81.3%, x 2 Z4.03, PZ0.045 for log-rank test). Post-operative calcitonin was the only predictor significantly associated with the 10-year progression of disease. Post-operative calcitonin levels R4.65 pg/ml predicted disease persistence (sensitivity 93.8% and specificity 90%) and R14.5 pg/ml predicted disease progression (sensitivity 100%, specificity 82%, receiver operating characteristic curve analysis). Conclusions: Tumour size may be of clinical importance only in patients with MTCs O1 cm in size. Post-operative calcitonin is a more important predictor than size for disease progression.

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“…There was a strong association between the intratumoral lymphatic vessels and regional lymph node metastases for papillary thyroid carcinomas, suggesting that proliferation and invasion of new lymphatic vessels into the tumor play a role in its spread through lymphatic vessels [4]. Follicular thyroid carcinomas metastasize to the distant organs through hematogenous spread rather than through lymph spread [8].…”

Section: Discussionmentioning

confidence: 99%

“…Machens and Dralle analyzed 715 cases of MTC and found that 10%, 8% and 5% were diagnosed with lung, liver and bone metastasis, respectively [3]. Recently, there is an increased detection of micro-MTC thanks to the routine measurement of serum calcitonin levels [4]. Sporadic MTCs account for 80% of the carcinomas whereas 20% have a familial basis [5] [6].…”

Section: Introductionmentioning

confidence: 99%

Tumor-Associated Lymphatic and Venous Vessels in Medullary Thyroid Carcinomas

Tomita

2015

OJPathology

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Objective: Medullary thyroid carcinomas (MTCs) invade local lymph node through lymphatic vessels and metastasize to distant organs hematogenously and account for a significant mortality. There are possibly increased lymphatic and venous vessels, through which the tumor spreads to lymph nodes and distant organs. Materials and Methods: By immunocytochemical staining for lymphatic and venous vessels, MTC lesions with adjacent normal thyroid and both normal and metastatic lymph nodes were studied for the peritumoral lymphatic and venous vessels, which were morphometrically compared with those of normal thyroid and lymph nodes. Sixteen cases of MTC cases with adjacent thyroid tissues and attached lymph nodes were immunocytochemically stained for lymphatic vessels using lymphatic vessel hyaluronan receptor (LYVE-1) and venous vessels for factor VIII (F-8). The immunostained sections of MTC lesions and metastatic lymph nodes were morphometrically compared for the number and sizes of the vessels with those of normal thyroid tissues and lymph nodes. Results: Significantly increased lymphatic vessels and markedly increased blood vessels were identified in many MTC cases at the peritumoral tissues and metastatic lymph nodes whereas a few lymphatic vessels and no venous vessels were identified in midst of MTCs. The irregular peritumoral lymphatic vessels resembled that of immature lymphatic vessels observed in papillary thyroid carcinomas and increased irregularly, entrapped venous vessels in peritumoral tissues resembled those observed in follicular thyroid carcinomas. Conclusion: The significantly increased lymphatic vessels and markedly increased venous vessels in the peritumoral thyroid tissue support a propensity of MTCs for providing an easy access of tumor cells to both lymphatic spread to the regional lymph nodes and venous spread to distant organs with further tumor spread through metastatic lymph nodes by moderately increased lymphatic and venous vessels.

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Medullary thyroid carcinoma: the influence of policy changing in clinical characteristics and disease progression

Abstract: Objective: Medullary thyroid carcinoma (MTC) has varying clinical course. We assessed trends in MTC presentation during the last 34 years. Design: Retrospective study. Methods: One hundred and fifty one patients (44.4% males) were followed for 0.9-34 years.

Cited by 20 publications

References 48 publications

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

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

Small medullary thyroid carcinoma: post-operative calcitonin rather than tumour size predicts disease persistence and progression

Tumor-Associated Lymphatic and Venous Vessels in Medullary Thyroid Carcinomas

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