Distant metastasis in medullary thyroid carcinoma: Clinical outcomes and implications of T stage. (5th April 2022)

• Record Type: Journal Article
• Authors: Shao, Yuting; Li, Genpeng; Wei, Tao; Gong, Rixiang; Li, Zhihui; Zhu, Jingqiang; Lei, Jianyong
• Is Part Of: Clinical endocrinology. Volume 97:Number 5(2022)
• Page Start: 676
• Page End: 684
• Publication Date: 2022-04-05
• Subjects: distant metastasis -- medullary thyroid carcinoma -- T stage; Endocrinology -- Periodicals; 616.4005
• DOI: 10.1111/cen.14717
• Languages: English
• ISSNs: 0300-0664

Abstract

Abstract: Background: The eighth edition of the American Joint Committee on Cancer tumour, node, and metastasis staging system did not take T stage into consideration when evaluating Stage IV C medullary thyroid carcinoma (MTC) patients. The aim of this study is to investigate the clinical outcomes and implications of T stage in this population. Methods: Eligible patients from the Surveillance, Epidemiology, and End Results database and the Department of Thyroid Surgery in West China Hospital of Sichuan University and who were diagnosed with Stage IV C MTC were included in this study. The overall survival (OS), the cancer‐specific survival (CSS), and the precise cause of MTC‐induced death were analysed. The potential risk factors, including the T stage, in the OS and CSS were evaluated by univariate and multivariate Cox regression models. Results: This retrospective study enroled 204 Stage IV C MTC patients. The 5‐ and 10‐year OS rates were 31.8% and 17.1%, respectively, and the 5‐ and 10‐year CSS rates were 40.4% and 22.5%, respectively. More importantly, the rates of MTC‐induced death between primary or distant metastatic lesions in Stage IV C MTC patients were comparable in our institution. Additionally, the univariate and multivariate analyses demonstrated that the presence of an advanced T stage was an independent prognostic factor for both the OS (T4 vs. T1–T3, hazard ratio [HR]: 1.714, 95% confidence interval [CI]: 1.175–2.500, p = .005) and the CSS (T4 vs. T1–T3, HR: 1.848, 95% CI: 1.229–2.780, p = .003). Conclusion: To achieve a better risk stratification, further classification of Stage IV C MTC patients by the T stage may be preferable.