Medullary Thyroid Cancer: Single Institute Experience Over 3 Decades and Risk Factors for Recurrence
An erratum to this article was published (J Clin Endocrinol Metab, 16 Sep 2025 ↗)
Authors' conclusion
One of 4 patients undergoing surgery for MTC will recur. Risk factors associated with recurrence are male gender, lateral lymph node metastasis, and high/highest MTC risk level mutations, but not necessarily surgery type. Preoperative calcitonin >2175 pg/mL is suggestive of advanced disease and should prompt further evaluation.
Study context
- Population
- Patients with medullary thyroid cancer (MTC) who underwent surgery, single specialized tertiary care referral center, 1990–2023; mean age 54.9 years, 65% female
- Participants
- 68 patients
- Exposure
- Total thyroidectomy (TT) vs TT + central neck dissection (CND) vs TT + CND + lateral neck dissection (LND)
- TTn = 10
- TT + CNDn = 28
- TT + CND + LNDn = 25
- Outcome
- Recurrence
- Follow-up
- Median 4.7 years (1.2-28.0)
Methodological detailssingle-centre, tertiary care referral center
- Single-centre
- Tertiary care referral center
Main finding
As reported in the abstract
- Recurrence
- 22%
- Male gender associated with recurrence: HR
- 5.81, P = .021
- Positive lateral neck nodes associated with recurrence: HR
- 8.10, P = .011
- High/highest MTC risk level RET mutations associated with recurrence: HR
- 8.66, P = .004
- Extent of surgery not significantly associated with recurrence
- P = .634
Observational data: associations, not effects.
Further findings
Preoperative calcitonin >2175 pg/mL as predictor
- Distant metastasis (strong predictor): AUC
- 0.893
- Lateral neck disease (good predictor): AUC
- 0.706
Baseline disease features
- Lymph node metastases
- 24% (n = 16)
- Distant metastases
- 4% (n = 3)
- RET mutations
- 52% (n = 35)
- MTC risk levels: highest / high / moderate
- 6% / 7% / 39%
- Mean tumor size, cm
- 1.9 (1.2-3.2)
- Mean preoperative calcitonin, pg/mL
- 504.4 (133.2-1833.8)
- Positive central nodes on final pathology
- 40%
- Positive lateral nodes on final pathology
- 25%
Original publication
Medullary Thyroid Cancer: Single Institute Experience Over 3 Decades and Risk Factors for Recurrence. J Clin Endocrinol Metab. Published 23 April 2024. doi:10.
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