Postoperative biochemical remission of serum calcitonin is the best predictive factor for recurrence-free survival of medullary thyroid cancer

A large-scale retrospective analysis over 30 years

Kyong Yeun Jung, Seok Mo Kim, Won Sang Yoo, Bup Woo Kim, Yong Sang Lee, Kyung Won Kim, Kyu Eun Lee, Jong Ju Jeong, Kee Hyun Nam, Se Hoon Lee, Jeong Hun Hah, Woong Youn Chung, Ka Hee Yi, Do Joon Park, Yeo Kyu Youn, Myung Whun Sung, Bo Youn Cho, Cheong Soo Park, Young Joo Park, Hang-Seok Chang

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Abstract

Summary Context The increase in thyroid screening in the general population may lead to earlier detection of medullary thyroid carcinoma (MTC). Objective We aimed to evaluate secular trends in clinicopathological characteristics and long-term prognosis of MTC and its prognostic factors. Design This was a retrospective analysis from 1982 to 2012. Patients Three hundred and thirty-one patients with MTC were included and grouped based on the year of diagnosis (1982-2000, 2001-2005, 2006-2010 and 2011-2012). Measurements These included recurrence and mortality as well as biochemical remission (BCR) of serum calcitonin. Results Mean tumour size (from 2·5 cm to 1·7 cm, P < 0·001) and percentage of extrathyroidal extension (from 52·0% to 26·0%, P = 0·026) decreased. The percentage of patients achieving BCR within six postoperative months (po-BCR) increased with time (from 39·6% to 76·1%, P < 0·001). The 5-year overall recurrence rate significantly decreased in 2006-2012 compared to 1982-2005 (10% vs 18%, respectively, P = 0·031), although the 5-year survival rate did not improve (92% vs 92%, P = 0·929). Failure to achieve po-BCR was the strongest predictive factor associated with recurrence (hazard ratio [HR] = 58·04, 95% CI 7·14-472·11; P < 0·001). Male gender (HR = 3·18, 95% CI 1·18-8·56; P = 0·022), tumour size >2 cm (HR = 18·33, 95% CI 2·35-143·06; P = 0·006) and distant metastasis (HR = 4·00, 95% CI 1·31-12·21; P = 0·015) were significant prognostic factors for mortality. Conclusions Clinicopathological characteristics and recurrence of MTC improved with time. Po-BCR was the best predictive factor for recurrence-free survival.

Original languageEnglish
Pages (from-to)587-597
Number of pages11
JournalClinical Endocrinology
Volume84
Issue number4
DOIs
Publication statusPublished - 2016 Apr 1

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Calcitonin
Recurrence
Survival
Serum
Mortality
Thyroid Gland
Neoplasm Metastasis
Medullary Thyroid cancer
Population
Neoplasms

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Jung, Kyong Yeun ; Kim, Seok Mo ; Yoo, Won Sang ; Kim, Bup Woo ; Lee, Yong Sang ; Kim, Kyung Won ; Lee, Kyu Eun ; Jeong, Jong Ju ; Nam, Kee Hyun ; Lee, Se Hoon ; Hah, Jeong Hun ; Chung, Woong Youn ; Yi, Ka Hee ; Park, Do Joon ; Youn, Yeo Kyu ; Sung, Myung Whun ; Cho, Bo Youn ; Park, Cheong Soo ; Park, Young Joo ; Chang, Hang-Seok. / Postoperative biochemical remission of serum calcitonin is the best predictive factor for recurrence-free survival of medullary thyroid cancer : A large-scale retrospective analysis over 30 years. In: Clinical Endocrinology. 2016 ; Vol. 84, No. 4. pp. 587-597.
@article{e03d3f52401b426d8c905262c9e3d07b,
title = "Postoperative biochemical remission of serum calcitonin is the best predictive factor for recurrence-free survival of medullary thyroid cancer: A large-scale retrospective analysis over 30 years",
abstract = "Summary Context The increase in thyroid screening in the general population may lead to earlier detection of medullary thyroid carcinoma (MTC). Objective We aimed to evaluate secular trends in clinicopathological characteristics and long-term prognosis of MTC and its prognostic factors. Design This was a retrospective analysis from 1982 to 2012. Patients Three hundred and thirty-one patients with MTC were included and grouped based on the year of diagnosis (1982-2000, 2001-2005, 2006-2010 and 2011-2012). Measurements These included recurrence and mortality as well as biochemical remission (BCR) of serum calcitonin. Results Mean tumour size (from 2·5 cm to 1·7 cm, P < 0·001) and percentage of extrathyroidal extension (from 52·0{\%} to 26·0{\%}, P = 0·026) decreased. The percentage of patients achieving BCR within six postoperative months (po-BCR) increased with time (from 39·6{\%} to 76·1{\%}, P < 0·001). The 5-year overall recurrence rate significantly decreased in 2006-2012 compared to 1982-2005 (10{\%} vs 18{\%}, respectively, P = 0·031), although the 5-year survival rate did not improve (92{\%} vs 92{\%}, P = 0·929). Failure to achieve po-BCR was the strongest predictive factor associated with recurrence (hazard ratio [HR] = 58·04, 95{\%} CI 7·14-472·11; P < 0·001). Male gender (HR = 3·18, 95{\%} CI 1·18-8·56; P = 0·022), tumour size >2 cm (HR = 18·33, 95{\%} CI 2·35-143·06; P = 0·006) and distant metastasis (HR = 4·00, 95{\%} CI 1·31-12·21; P = 0·015) were significant prognostic factors for mortality. Conclusions Clinicopathological characteristics and recurrence of MTC improved with time. Po-BCR was the best predictive factor for recurrence-free survival.",
author = "Jung, {Kyong Yeun} and Kim, {Seok Mo} and Yoo, {Won Sang} and Kim, {Bup Woo} and Lee, {Yong Sang} and Kim, {Kyung Won} and Lee, {Kyu Eun} and Jeong, {Jong Ju} and Nam, {Kee Hyun} and Lee, {Se Hoon} and Hah, {Jeong Hun} and Chung, {Woong Youn} and Yi, {Ka Hee} and Park, {Do Joon} and Youn, {Yeo Kyu} and Sung, {Myung Whun} and Cho, {Bo Youn} and Park, {Cheong Soo} and Park, {Young Joo} and Hang-Seok Chang",
year = "2016",
month = "4",
day = "1",
doi = "10.1111/cen.12852",
language = "English",
volume = "84",
pages = "587--597",
journal = "Clinical Endocrinology",
issn = "0300-0664",
publisher = "Wiley-Blackwell",
number = "4",

}

Jung, KY, Kim, SM, Yoo, WS, Kim, BW, Lee, YS, Kim, KW, Lee, KE, Jeong, JJ, Nam, KH, Lee, SH, Hah, JH, Chung, WY, Yi, KH, Park, DJ, Youn, YK, Sung, MW, Cho, BY, Park, CS, Park, YJ & Chang, H-S 2016, 'Postoperative biochemical remission of serum calcitonin is the best predictive factor for recurrence-free survival of medullary thyroid cancer: A large-scale retrospective analysis over 30 years', Clinical Endocrinology, vol. 84, no. 4, pp. 587-597. https://doi.org/10.1111/cen.12852

Postoperative biochemical remission of serum calcitonin is the best predictive factor for recurrence-free survival of medullary thyroid cancer : A large-scale retrospective analysis over 30 years. / Jung, Kyong Yeun; Kim, Seok Mo; Yoo, Won Sang; Kim, Bup Woo; Lee, Yong Sang; Kim, Kyung Won; Lee, Kyu Eun; Jeong, Jong Ju; Nam, Kee Hyun; Lee, Se Hoon; Hah, Jeong Hun; Chung, Woong Youn; Yi, Ka Hee; Park, Do Joon; Youn, Yeo Kyu; Sung, Myung Whun; Cho, Bo Youn; Park, Cheong Soo; Park, Young Joo; Chang, Hang-Seok.

In: Clinical Endocrinology, Vol. 84, No. 4, 01.04.2016, p. 587-597.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Postoperative biochemical remission of serum calcitonin is the best predictive factor for recurrence-free survival of medullary thyroid cancer

T2 - A large-scale retrospective analysis over 30 years

AU - Jung, Kyong Yeun

AU - Kim, Seok Mo

AU - Yoo, Won Sang

AU - Kim, Bup Woo

AU - Lee, Yong Sang

AU - Kim, Kyung Won

AU - Lee, Kyu Eun

AU - Jeong, Jong Ju

AU - Nam, Kee Hyun

AU - Lee, Se Hoon

AU - Hah, Jeong Hun

AU - Chung, Woong Youn

AU - Yi, Ka Hee

AU - Park, Do Joon

AU - Youn, Yeo Kyu

AU - Sung, Myung Whun

AU - Cho, Bo Youn

AU - Park, Cheong Soo

AU - Park, Young Joo

AU - Chang, Hang-Seok

PY - 2016/4/1

Y1 - 2016/4/1

N2 - Summary Context The increase in thyroid screening in the general population may lead to earlier detection of medullary thyroid carcinoma (MTC). Objective We aimed to evaluate secular trends in clinicopathological characteristics and long-term prognosis of MTC and its prognostic factors. Design This was a retrospective analysis from 1982 to 2012. Patients Three hundred and thirty-one patients with MTC were included and grouped based on the year of diagnosis (1982-2000, 2001-2005, 2006-2010 and 2011-2012). Measurements These included recurrence and mortality as well as biochemical remission (BCR) of serum calcitonin. Results Mean tumour size (from 2·5 cm to 1·7 cm, P < 0·001) and percentage of extrathyroidal extension (from 52·0% to 26·0%, P = 0·026) decreased. The percentage of patients achieving BCR within six postoperative months (po-BCR) increased with time (from 39·6% to 76·1%, P < 0·001). The 5-year overall recurrence rate significantly decreased in 2006-2012 compared to 1982-2005 (10% vs 18%, respectively, P = 0·031), although the 5-year survival rate did not improve (92% vs 92%, P = 0·929). Failure to achieve po-BCR was the strongest predictive factor associated with recurrence (hazard ratio [HR] = 58·04, 95% CI 7·14-472·11; P < 0·001). Male gender (HR = 3·18, 95% CI 1·18-8·56; P = 0·022), tumour size >2 cm (HR = 18·33, 95% CI 2·35-143·06; P = 0·006) and distant metastasis (HR = 4·00, 95% CI 1·31-12·21; P = 0·015) were significant prognostic factors for mortality. Conclusions Clinicopathological characteristics and recurrence of MTC improved with time. Po-BCR was the best predictive factor for recurrence-free survival.

AB - Summary Context The increase in thyroid screening in the general population may lead to earlier detection of medullary thyroid carcinoma (MTC). Objective We aimed to evaluate secular trends in clinicopathological characteristics and long-term prognosis of MTC and its prognostic factors. Design This was a retrospective analysis from 1982 to 2012. Patients Three hundred and thirty-one patients with MTC were included and grouped based on the year of diagnosis (1982-2000, 2001-2005, 2006-2010 and 2011-2012). Measurements These included recurrence and mortality as well as biochemical remission (BCR) of serum calcitonin. Results Mean tumour size (from 2·5 cm to 1·7 cm, P < 0·001) and percentage of extrathyroidal extension (from 52·0% to 26·0%, P = 0·026) decreased. The percentage of patients achieving BCR within six postoperative months (po-BCR) increased with time (from 39·6% to 76·1%, P < 0·001). The 5-year overall recurrence rate significantly decreased in 2006-2012 compared to 1982-2005 (10% vs 18%, respectively, P = 0·031), although the 5-year survival rate did not improve (92% vs 92%, P = 0·929). Failure to achieve po-BCR was the strongest predictive factor associated with recurrence (hazard ratio [HR] = 58·04, 95% CI 7·14-472·11; P < 0·001). Male gender (HR = 3·18, 95% CI 1·18-8·56; P = 0·022), tumour size >2 cm (HR = 18·33, 95% CI 2·35-143·06; P = 0·006) and distant metastasis (HR = 4·00, 95% CI 1·31-12·21; P = 0·015) were significant prognostic factors for mortality. Conclusions Clinicopathological characteristics and recurrence of MTC improved with time. Po-BCR was the best predictive factor for recurrence-free survival.

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DO - 10.1111/cen.12852

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