Survival in patients with medullary thyroid cancer after less than the recommended initial operation. Issue 6 (19th December 2017)

• Record Type: Journal Article
• Authors: Randle, Reese W.; Bates, Maria F.; Schneider, David F.; Sippel, Rebecca S.; Pitt, Susan C.
• Is Part Of: Journal of surgical oncology. Volume 117:Issue 6(2018)
• Page Start: 1211
• Page End: 1216
• Publication Date: 2017-12-19
• Subjects: disease specific survival -- extent of operation -- medullary thyroid cancer -- SEER -- thyroidectomy; Cancer -- Surgery -- Periodicals; Neoplasms -- Periodicals; 616
• DOI: 10.1002/jso.24954
• Languages: English
• ISSNs: 0022-4790

Abstract

Abstract : Background and Objectives: We aimed to evaluate the disease specific‐survival (DSS) of patients with Medullary Thyroid Cancer (MTC) confined to the central neck based on the extent of the initial operation. Methods: This retrospective review of patients with MTC from the SEER registry from 2004 to 2012 excluded patients with lateral neck involvement or distant metastases. Results: The cohort ( n = 766) included 85(11%) less than total thyroidectomies (TT), 212(28%) TT alone, and 469(61%) TT with lymph node excision. Mean tumor size was similar (2.2cm for <TT, 1.9 for TT alone, and 2.2 for TT with nodes, p=0.13). Patients receiving a TT with nodal excision were more likely to have multifocal tumors (8% <TT, 22% TT alone, and 27% TT with nodes, P < 0.001), and extrathyroidal extension (1% <TT, 4% TT alone, and 9% TT with nodes, P = 0.005). Even after controlling for significant predictors of DSS, extent of the initial operation did not predict survival (HR 0.28 for <TT, 95% CI 0.26‐3.11 and HR 0.62 for TT alone, 95% CI 0.17‐2.22 compared to TT with nodes, P = NS for all). Conclusion: According to population‐based SEER registry data, the extent of initial resection may not significantly change DSS in patients with MTC confined to the central neck.