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Cure and survival of sporadic medullary thyroid carcinoma following systematic preoperative calcitonin screening

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Abstract

Background

The improvement in outcome of sporadic medullary thyroid carcinoma (MTC) during the last decades remains controversial, even if a trend toward a better prognosis has been recently proposed. This study was aimed to determine the time trend cure and survival rates in sporadic MTC according to the use of systematic preoperative calcitonin screening.

Methods

Retrospective analysis of 178 sporadic MTC patients operated between 1980 and 2017 was performed. The impact of prognostic factors on cure and survival following the introduction of routine preoperative calcitonin screening in 2001 was evaluated according to the year of surgery.

Results

Since 2001, a significant decline of node-positive tumors (from 56.1 to 34.7%) and advanced stage at diagnosis (stage III/IV from 56.1 to 34.7%) occurred, with a concomitant significant increase in cure rate (64.5% vs 38.6%; p = 0.0012) and survival (p < 0.05). At univariate analysis, the cure was achieved more frequently in more recently operated patients (64.5% vs 38.6%; p = 0.0012), in disease staging I/II (86.5% vs 13.5%; p < 0.0001), in patients undergoing preoperative calcitonin screening (63.8% vs 23.5%; p < 0.0001) and in the absence of lymph node metastases (86.5% vs 13.5%; p < 0.0001). At multivariate analysis, only preoperative calcitonin screening and stage at diagnosis turned out to be significant independent prognostic factors for cure and survival.

Conclusion

The outcome of sporadic MTC improved in the new millennium; diagnosis was achieved earlier, at a less advanced stage. Routine preoperative calcitonin screening may have contributed to improve cure and survival rates.

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Author notes

  1. Francesca Torresan and Caterina Mian contributed equally to this work.

Authors and Affiliations

  1. Endocrine Surgery Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, Via Giustiniani 2, 35128, Padua, Italy

    Francesca Torresan & Maurizio Iacobone

  2. Endocrinology Unit, Department of Medicine, University of Padua, Padua, Italy

    Caterina Mian & Elisabetta Cavedon

Authors
  1. Francesca Torresan
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  2. Caterina Mian
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  3. Elisabetta Cavedon
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  4. Maurizio Iacobone
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Contributions

Francesca Torresan: study conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript. Caterina Mian: study conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript. Elisabetta Cavedon: acquisition of data and Critical revision of the manuscript. Maurizio Iacobone: study conception and design, acquisition of data, analysis and interpretation of data, drafting of the manuscript, and critical revision of the manuscript.

Corresponding author

Correspondence to Maurizio Iacobone.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study (retrospective analysis), formal consent is not required. The study was approved by the Institution Review Board.

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Torresan, F., Mian, C., Cavedon, E. et al. Cure and survival of sporadic medullary thyroid carcinoma following systematic preoperative calcitonin screening. Langenbecks Arch Surg 404, 411–419 (2019). https://doi.org/10.1007/s00423-019-01764-3

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  • DOI: https://doi.org/10.1007/s00423-019-01764-3

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