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Clinicopathological Significance and Prognosis of Medullary Thyroid Microcarcinoma: A Meta-analysis

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Abstract

Background

The objective of the present meta-analysis was to evaluate the clinicopathological significance and prognosis of micro-MTC compared to macro-MTC.

Methods

Relevant articles were obtained by searching the PubMed and MEDLINE databases. A meta-analysis was performed using 15 eligible studies. In addition, subgroup analysis based on heredity was performed in patients diagnosed with micro-MTC.

Results

The rate of extrathyroidal extension of micro-MTC [0.118 (95% CI 0.073–0.185)] was significantly lower than that of macro-MTC [0.303 (95% CI 0.224–0.395)]. Micro-MTC [0.229 (95% CI 0.161–0.314)] had a significantly lower rate of cervical lymph node (LN) metastasis compared to macro-MTC [0.595 (95% CI 0.486–0.694)]. The rate of multifocality was not significantly different between micro-MTC and macro-MTC [0.394 (95% CI 0.244–0.566) vs. 0.320 (95% CI 0.234–0.421), respectively]. The rate of distant metastasis did not differ significantly between micro-MTC [0.082 (95% CI 0.017–0.314)] and macro-MTC [0.068 (95% CI 0.009–0.376)]. Patients with micro-MTC showed significantly higher disease-free survival rates [hazard ratio [HR] 0.406 (95% CI 0.288–0.575), I 2 = 40.563%] compared to patients with macro-MTC.

Conclusion

Micro-MTC has aggressive features, such as multifocality and distant metastasis, similar to macro-MTC and a non-negligible rate of extrathyroidal extension and cervical LN metastasis. We suggest that treatment of micro-MTC should be approached with a similar focus as that of macro-MTC. Considering that less extrathyroidal extension and cervical LN metastasis occur in patients with micro-MTC compared to macro-MTC, we propose that treatment of micro-MTC, which has a relatively low disease burden status, should be viewed as an opportunity for improving prognosis.

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Acknowledgements

This study was supported by research fund from Chosun University Hospital, 2016.

Author information

Author notes

  1. Jin Hwa Kim and Jung-Soo Pyo have contributed equally to this study.

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Republic of Korea

    Jin Hwa Kim

  2. Department of Pathology, Eulji University Hospital, Eulji University College of Medicine, Daejeon, Republic of Korea

    Jung-Soo Pyo

  3. Department of Urology, Chosun University Hospital, Chosun University School of Medicine, 365 Pilmundaero, Dong-gu, Gwangju, 501-717, Republic of Korea

    Won Jin Cho

  4. Study Group for Meta-analysis, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Republic of Korea

    Jin Hwa Kim & Won Jin Cho

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  1. Jin Hwa Kim
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Correspondence to Won Jin Cho.

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Kim, J.H., Pyo, JS. & Cho, W.J. Clinicopathological Significance and Prognosis of Medullary Thyroid Microcarcinoma: A Meta-analysis. World J Surg 41, 2551–2558 (2017). https://doi.org/10.1007/s00268-017-4031-6

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