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Long-Term Outcome After Surgery for Medullary Thyroid Carcinoma: A Single-Center Experience

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Abstract

Background

Medullary thyroid carcinoma (MTC) is a rare C cells-derived tumor, with a hardly predictable long-term prognosis. This study was aimed to evaluate the predictive factors of cure and survival after surgery for MTC in a monocentric series.

Methods

A retrospective analysis of the long-term outcomes was assessed in 255 MTC patients operated between 1980 and 2015 at Padua University hospital.

Results

Sporadic MTC occurred in 65.1% and hereditary MTC in 34.9% of patients. At a median follow-up of 93 months (range 7–430), the cure rate was 56.8%. The overall 10-year survival was 84.4%, and MTC-related death rate was 15.3%. Patients who died because of MTC had a median age of 61 years (range 21–84) and were at stages III–IV in all cases; deaths occurred in 18% of sporadic MTC, 6% of MEN2a and 66.7% of MEN2b patients. None of the patients at stages I–II died because of the disease, but 17.7% had persistent/recurrent disease. Based on univariate analysis, age, gender, genetic variant, extent and year of surgery, tumor size, lymph-nodal metastases and tumor stage significantly affected cure and survival rates. At multivariate analysis, only patient- and tumor-related features (age, lymph-nodal status and stage) remained significant independent prognostic factors.

Conclusions

Radical surgery is the only chance of definitive cure in MTC, but it is possible only at early stage; in advanced stages, even extensive surgery could not grant cure and prolonged survival. Stage, nodal metastases and age remain the main predictive factors for cure and survival.

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Acknowledgements

The authors thank Dr. Senthilkumar Rajendran for assistance in the revision of the English.

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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

    Elisabetta Cavedon & Caterina Mian

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

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Torresan, F., Cavedon, E., Mian, C. et al. Long-Term Outcome After Surgery for Medullary Thyroid Carcinoma: A Single-Center Experience. World J Surg 42, 367–375 (2018). https://doi.org/10.1007/s00268-017-4321-z

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