The Journal of clinical endocrinology and metabolism · 2025
Tumor Volume Doubling Time of Less Than 1 Year Is Associated With a Higher Risk of Death From Medullary Thyroid Cancer.
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Behairy Noha, Leonardi Anthony J, Gubbi Sriram, Kumari Sonam, Pascoal Mateus, Bharadwaj Ashwin, Dorgham Amr, Wright Elizabeth C, Abijo Tomilowo, Uttarkar Vikram Chandra Nayan, Veeraraghavan Padmasree, Cochran Craig, Akshintala Srivandana, Glod John, Klubo-Gwiezdzinska Joanna
Аннотация
CONTEXT: Tumor volume doubling time (TVDT) is emerging as a useful tool in predicting oncologic outcomes. There are limited data on the prognostic role of TVDT in metastatic medullary thyroid cancer (MTC).
OBJECTIVE: The goal of this study was to assess the value of TVDT in predicting disease-specific survival (DSS) in patients with hereditary and sporadic MTC.
METHODS: This was an Institutional Review Board-approved cohort study including patients with metastatic MTC having at least 3 consecutive imaging studies. TVDT of up to the 5 largest lesions per organ was calculated using a standardized formula. The association between TVDT and DSS was analyzed using Kaplan-Meier survival curves. Cox proportional regression model was used to account for confounding factors.
RESULTS: The study sample consisted of 51 patients presenting with 286 metastatic lesions measured with 457 scans during the follow-up of 51 (IQR, 25-102) months. Median age was 19 years (IQR, 15-41), 53% female patients. Cumulative volumes of all metastatic lesions and proportion of patients with TVDT of < 1 year were higher in patients with sporadic as compared with hereditary MTC (P < .01). Factors independently associated with shorter DSS were TVDT of < 1 year based on 3 initial and 3 last scans as well as lung, brain, and prostate as the organs with the fastest growing tumor. TVDT based on 2-dimensional and 3-dimensional measurements showed strong correlation (r = 0.94, P < .05).
CONCLUSION: Measurements from 3 baseline and 3 most recent scans preceding follow-up visit enable calculation of TVDT and can be used as predictors of mortality from MTC.
OBJECTIVE: The goal of this study was to assess the value of TVDT in predicting disease-specific survival (DSS) in patients with hereditary and sporadic MTC.
METHODS: This was an Institutional Review Board-approved cohort study including patients with metastatic MTC having at least 3 consecutive imaging studies. TVDT of up to the 5 largest lesions per organ was calculated using a standardized formula. The association between TVDT and DSS was analyzed using Kaplan-Meier survival curves. Cox proportional regression model was used to account for confounding factors.
RESULTS: The study sample consisted of 51 patients presenting with 286 metastatic lesions measured with 457 scans during the follow-up of 51 (IQR, 25-102) months. Median age was 19 years (IQR, 15-41), 53% female patients. Cumulative volumes of all metastatic lesions and proportion of patients with TVDT of < 1 year were higher in patients with sporadic as compared with hereditary MTC (P < .01). Factors independently associated with shorter DSS were TVDT of < 1 year based on 3 initial and 3 last scans as well as lung, brain, and prostate as the organs with the fastest growing tumor. TVDT based on 2-dimensional and 3-dimensional measurements showed strong correlation (r = 0.94, P < .05).
CONCLUSION: Measurements from 3 baseline and 3 most recent scans preceding follow-up visit enable calculation of TVDT and can be used as predictors of mortality from MTC.