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Published in: European Journal of Medical Research 1/2023

Open Access 01-12-2023 | Metastasis | Research

Clinicopathological characteristics and prognosis of medullary thyroid microcarcinoma: a tumor with a similar prognosis to macrocarcinoma

Authors: Xin Wu, Binglu Li, Chaoji Zheng

Published in: European Journal of Medical Research | Issue 1/2023

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Abstract

Background

Tumor size plays an important role in the staging and treatment of thyroid carcinoma. A tumor with a maximum diameter of 1 cm or less is referred to as microcarcinoma. It is unclear if the clinicopathological characteristics and prognosis of medullary thyroid microcarcinoma (≤ 1 cm; MTMC) and macrocarcinoma (> 1 cm) differ. The present study aims to clarify the clinical features and prognosis of patients with MTMC.

Methods

The patients with medullary thyroid carcinoma underwent radical operation at our hospital between December 2000 and January 2022 were retrospectively studied. A database was established for this study. Patients with MTMC and macrocarcinoma were grouped for comparison. The clinicopathological characteristics of the two groups were compared by χ2 test, Fisher’s exact test, t-test, and Mann–Whitney U test. Cumulative survival rates were presented by the Kaplan–Meier curves and compared using the log-rank test.

Results

A total of 198 patients were included. Of them, 56 and 142 with MTMC and macrocarcinoma, respectively. Few patients in the MTMC group had lateral lymph node metastasis. One hundred and seventy-eight (89.9%) patients were followed up, with a median follow-up period of 61 (35, 105) months. The disease-free survival rate was significantly higher in the MTMC group (log-rank test, p = 0.032); however, there was no significant difference in the overall survival rate between the two groups (log-rank test, p = 0.083).

Conclusions

Patients with MTMC have a lower risk of lateral lymph node metastasis and better disease-free survival than those with macrocarcinoma. However, there was no significant difference in the overall survival rate of both groups. MTMC should be treated in the same manner as macrocarcinoma.
Literature
1.
go back to reference Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.CrossRefPubMed Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–49.CrossRefPubMed
2.
go back to reference Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.CrossRefPubMed Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.CrossRefPubMed
3.
go back to reference Baloch ZW, Asa SL, Barletta JA, Ghossein RA, Juhlin CC, Jung CK, et al. Overview of the 2022 WHO classification of thyroid neoplasms. Endocr Pathol. 2022;33(1):27–63.CrossRefPubMed Baloch ZW, Asa SL, Barletta JA, Ghossein RA, Juhlin CC, Jung CK, et al. Overview of the 2022 WHO classification of thyroid neoplasms. Endocr Pathol. 2022;33(1):27–63.CrossRefPubMed
4.
go back to reference Wells SA Jr, Asa SL, Dralle H, Elisei R, Evans DB, Gagel RF, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015;25(6):567–610.CrossRefPubMedPubMedCentral Wells SA Jr, Asa SL, Dralle H, Elisei R, Evans DB, Gagel RF, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid. 2015;25(6):567–610.CrossRefPubMedPubMedCentral
5.
go back to reference Jayasinghe R, Basnayake O, Jayarajah U, Seneviratne S. Management of medullary carcinoma of the thyroid: a review. J Int Med Res. 2022;50(7):3000605221110698.CrossRefPubMed Jayasinghe R, Basnayake O, Jayarajah U, Seneviratne S. Management of medullary carcinoma of the thyroid: a review. J Int Med Res. 2022;50(7):3000605221110698.CrossRefPubMed
6.
go back to reference Jayarajah U, Wijekoon M, Seneviratne SA. Prophylactic prednisolone for the prevention of early and intermediate adverse effects of radioactive iodine therapy in patients with thyroid cancer: study protocol for a single-centre, phase II/III, randomized, double-blinded, placebo-controlled clinical trial. Trials. 2020;21(1):812.CrossRefPubMedPubMedCentral Jayarajah U, Wijekoon M, Seneviratne SA. Prophylactic prednisolone for the prevention of early and intermediate adverse effects of radioactive iodine therapy in patients with thyroid cancer: study protocol for a single-centre, phase II/III, randomized, double-blinded, placebo-controlled clinical trial. Trials. 2020;21(1):812.CrossRefPubMedPubMedCentral
7.
go back to reference Trimboli P, Castellana M, Virili C, Giorgino F, Giovanella L. Efficacy of vandetanib in treating locally advanced or metastatic medullary thyroid carcinoma according to RECIST Criteria: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2018;9:224.CrossRefPubMed Trimboli P, Castellana M, Virili C, Giorgino F, Giovanella L. Efficacy of vandetanib in treating locally advanced or metastatic medullary thyroid carcinoma according to RECIST Criteria: a systematic review and meta-analysis. Front Endocrinol (Lausanne). 2018;9:224.CrossRefPubMed
8.
go back to reference Tuttle RM, Morris LF, Haugen BR, Shah JP, Sosa JA, Rohren E, et al. Thyroid - Differentiated and Anaplastic Carcinoma. In: AJCC Cancer Staging Manual. 8th ed. New York: Springer, 2017: 873–90. Tuttle RM, Morris LF, Haugen BR, Shah JP, Sosa JA, Rohren E, et al. Thyroid - Differentiated and Anaplastic Carcinoma. In: AJCC Cancer Staging Manual. 8th ed. New York: Springer, 2017: 873–90.
9.
go back to reference Rosen JE, Lloyd RV, Brierley JD, et al. Thyroid - medullary. In: AJCC Cancer Staging Manual. 8th ed. New York: Springer, 2017: 891–901. Rosen JE, Lloyd RV, Brierley JD, et al. Thyroid - medullary. In: AJCC Cancer Staging Manual. 8th ed. New York: Springer, 2017: 891–901.
10.
go back to reference Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1–133.CrossRefPubMedPubMedCentral Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer: The American Thyroid Association Guidelines Task Force on Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2016;26(1):1–133.CrossRefPubMedPubMedCentral
11.
go back to reference Gao M, Ge M, Ji Q, Cheng R, Lu H, Guan H, et al. 2016 Chinese expert consensus and guidelines for the diagnosis and treatment of papillary thyroid microcarcinoma. Cancer Biol Med. 2017;14(3):203–11.CrossRefPubMedPubMedCentral Gao M, Ge M, Ji Q, Cheng R, Lu H, Guan H, et al. 2016 Chinese expert consensus and guidelines for the diagnosis and treatment of papillary thyroid microcarcinoma. Cancer Biol Med. 2017;14(3):203–11.CrossRefPubMedPubMedCentral
12.
go back to reference Mitchell AL, Gandhi A, Scott-Coombes D, Perros P. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130(S2):S150–60.CrossRefPubMedPubMedCentral Mitchell AL, Gandhi A, Scott-Coombes D, Perros P. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol. 2016;130(S2):S150–60.CrossRefPubMedPubMedCentral
13.
go back to reference Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral
14.
go back to reference Toumi A, DiGennaro C, Vahdat V, Jalali MS, Gazelle GS, Chhatwal J, et al. Trends in thyroid surgery and guideline-concordant care in the United States, 2007–2018. Thyroid. 2021;31(6):941–9.CrossRefPubMedPubMedCentral Toumi A, DiGennaro C, Vahdat V, Jalali MS, Gazelle GS, Chhatwal J, et al. Trends in thyroid surgery and guideline-concordant care in the United States, 2007–2018. Thyroid. 2021;31(6):941–9.CrossRefPubMedPubMedCentral
15.
go back to reference Kazaure HS, Roman SA, Sosa JA. Medullary thyroid microcarcinoma: a population-level analysis of 310 patients. Cancer. 2012;118(3):620–7.CrossRefPubMed Kazaure HS, Roman SA, Sosa JA. Medullary thyroid microcarcinoma: a population-level analysis of 310 patients. Cancer. 2012;118(3):620–7.CrossRefPubMed
16.
go back to reference Raffel A, Cupisti K, Krausch M, Wolf A, Schulte KM, Röher HD. Incidentally found medullary thyroid cancer: treatment rationale for small tumors. World J Surg. 2004;28(4):397–401.CrossRefPubMed Raffel A, Cupisti K, Krausch M, Wolf A, Schulte KM, Röher HD. Incidentally found medullary thyroid cancer: treatment rationale for small tumors. World J Surg. 2004;28(4):397–401.CrossRefPubMed
17.
go back to reference Hamy A, Pessaux P, Mirallié E, Mucci-Hennekinne S, Gibelin H, Mor-Martinez C, et al. Central neck dissection in the management of sporadic medullary thyroid microcarcinoma. Eur J Surg Oncol. 2005;31(7):774–7.CrossRefPubMed Hamy A, Pessaux P, Mirallié E, Mucci-Hennekinne S, Gibelin H, Mor-Martinez C, et al. Central neck dissection in the management of sporadic medullary thyroid microcarcinoma. Eur J Surg Oncol. 2005;31(7):774–7.CrossRefPubMed
18.
go back to reference Pillarisetty VG, Katz SC, Ghossein RA, Tuttle RM, Shaha AR. Micromedullary thyroid cancer: how micro is truly micro? Ann Surg Oncol. 2009;16(10):2875–81.CrossRefPubMed Pillarisetty VG, Katz SC, Ghossein RA, Tuttle RM, Shaha AR. Micromedullary thyroid cancer: how micro is truly micro? Ann Surg Oncol. 2009;16(10):2875–81.CrossRefPubMed
19.
go back to reference Kim JH, Pyo JS, Cho WJ. Clinicopathological significance and prognosis of medullary thyroid microcarcinoma: a meta-analysis. World J Surg. 2017;41(10):2551–8.CrossRefPubMed Kim JH, Pyo JS, Cho WJ. Clinicopathological significance and prognosis of medullary thyroid microcarcinoma: a meta-analysis. World J Surg. 2017;41(10):2551–8.CrossRefPubMed
20.
go back to reference Li X, Zhou W, Zhan W. Clinical and ultrasonographic features of medullary thyroid microcarcinomas compared with papillary thyroid microcarcinomas: a retrospective analysis. BMC Med Imaging. 2020;20(1):49.CrossRefPubMedPubMedCentral Li X, Zhou W, Zhan W. Clinical and ultrasonographic features of medullary thyroid microcarcinomas compared with papillary thyroid microcarcinomas: a retrospective analysis. BMC Med Imaging. 2020;20(1):49.CrossRefPubMedPubMedCentral
21.
go back to reference Machens A, Dralle H. Biological relevance of medullary thyroid microcarcinoma. J Clin Endocrinol Metab. 2012;97(5):1547–53.CrossRefPubMed Machens A, Dralle H. Biological relevance of medullary thyroid microcarcinoma. J Clin Endocrinol Metab. 2012;97(5):1547–53.CrossRefPubMed
22.
go back to reference Kesby N, Mechera R, Fuchs T, Papachristos A, Gild M, Tsang V, et al. Natural history and predictive factors of outcome in medullary thyroid microcarcinoma. J Clin Endocrinol Metab. 2023;108(10):2626–34.CrossRefPubMedPubMedCentral Kesby N, Mechera R, Fuchs T, Papachristos A, Gild M, Tsang V, et al. Natural history and predictive factors of outcome in medullary thyroid microcarcinoma. J Clin Endocrinol Metab. 2023;108(10):2626–34.CrossRefPubMedPubMedCentral
23.
go back to reference Haddad RI, Nasr C, Bischoff L, Busaidy NL, Byrd D, Callender G, et al. NCCN Guidelines Insights: Thyroid Carcinoma, Version 2.2018. J Natl Compr Canc Netw. 2018;16(12):1429–40.CrossRefPubMed Haddad RI, Nasr C, Bischoff L, Busaidy NL, Byrd D, Callender G, et al. NCCN Guidelines Insights: Thyroid Carcinoma, Version 2.2018. J Natl Compr Canc Netw. 2018;16(12):1429–40.CrossRefPubMed
24.
go back to reference Clark JR, Fridman TR, Odell MJ, Brierley J, Walfish PG, Freeman JL. Prognostic variables and calcitonin in medullary thyroid cancer. Laryngoscope. 2005;115(8):1445–50.CrossRefPubMed Clark JR, Fridman TR, Odell MJ, Brierley J, Walfish PG, Freeman JL. Prognostic variables and calcitonin in medullary thyroid cancer. Laryngoscope. 2005;115(8):1445–50.CrossRefPubMed
25.
go back to reference Miccoli P, Minuto MN, Ugolini C, Molinaro E, Basolo F, Berti P, et al. Clinically unpredictable prognostic factors in the outcome of medullary thyroid cancer. Endocr Relat Cancer. 2007;14(4):1099–105.CrossRefPubMed Miccoli P, Minuto MN, Ugolini C, Molinaro E, Basolo F, Berti P, et al. Clinically unpredictable prognostic factors in the outcome of medullary thyroid cancer. Endocr Relat Cancer. 2007;14(4):1099–105.CrossRefPubMed
26.
go back to reference Machens A, Dralle H. Prognostic impact of N staging in 715 medullary thyroid cancer patients: proposal for a revised staging system. Ann Surg. 2013;257(2):323–9.CrossRefPubMed Machens A, Dralle H. Prognostic impact of N staging in 715 medullary thyroid cancer patients: proposal for a revised staging system. Ann Surg. 2013;257(2):323–9.CrossRefPubMed
27.
go back to reference Scerrino G, Cocorullo G, Orlando G, Rotolo G, Corigliano A, Amato C, et al. Predictive factors for lymph node involvement in sporadic medullary thyroid microcarcinoma: a systematic review. Eur Rev Med Pharmacol Sci. 2022;26(3):1004–16.PubMed Scerrino G, Cocorullo G, Orlando G, Rotolo G, Corigliano A, Amato C, et al. Predictive factors for lymph node involvement in sporadic medullary thyroid microcarcinoma: a systematic review. Eur Rev Med Pharmacol Sci. 2022;26(3):1004–16.PubMed
Metadata
Title
Clinicopathological characteristics and prognosis of medullary thyroid microcarcinoma: a tumor with a similar prognosis to macrocarcinoma
Authors
Xin Wu
Binglu Li
Chaoji Zheng
Publication date
01-12-2023
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2023
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-023-01534-4

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