The impact of microscopic extrathyroidal extension on the prognosis of medullary thyroid carcinoma: A multicenter cohort study.
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Ozturk Beyza Olcay, Keskin Umran, Uysal Serhat, Hacioglu Aysa, Karsli Seda, Andac Burak, Ozbay Umit Nur, Sodan Hulyanur, Burhan Sebnem, Ates Coskun, Avci Ugur, Kilinc Faruk, Erol Selvinaz, Catak Merve, Pekkolay Zafer, Akbaba Gulhan, Yorulmaz Goknur, Tekin Sakin, Topcu Birol, Tuna Mazhar Muslum, Kadioglu Pinar, Gonen Mustafa Sait, Ozdamar Karaca Zuleyha Cihan, Ciftci Sema, Celik Mehmet, Guldiken Sibel, Tuzun Dilek, Akturk Mujde, Altuntas Yuksel, Niyazoglu Mutlu, Cinar Nese, Gul Ozen Oz, Kebapci Medine Nur, Akalin Aysen, Bayraktaroglu Taner, Elbuken Gulsah, Zuhur Sayid Shafi
Аннотация
METHODS: This multicenter study included 208 patients with MTC (17.8% with hereditary disease). Patients with mETE were compared to those without mETE in terms of clinical and histopathological variables.
RESULTS: Among the 208 patients, 16.3% (n=34) had mETE on histopathological analysis. Patients with mETE were more likely to have larger tumors, higher serum calcitonin (CTN) levels before and after surgery, increased rates of neck lymph node (LN) and distant metastasis, multifocal disease, and advanced disease stage. Kaplan-Meier analysis showed a significantly lower DFS in patients with mETE than those without mETE (14.7% vs. 71.3%, log-rank p<0.001). However, mETE was not an independent contributing factor for persistent/recurrent disease, whereas neck LN involvement was the strongest independent contributing factor for persistent/recurrent disease (HR: 1.1; 95% CI 0.4-1.8, p=0.76 and HR: 9.6; 95% CI 1.21-76.9, p=0.03, respectively).
CONCLUSION: mETE in patients with MTC is associated with a lower DFS, larger tumor sizes, a higher likelihood of neck LN and distant metastasis, advanced stage, higher serum CTN levels, multifocality, and persistent/recurrent disease. However, mETE was not an independent predictor of persistent/recurrent disease. Further studies with a larger number of patients with mETE could further clarify the impact of mETE on the prognosis of MTC.