The Usefulness of the International Grading System in the Management of Sporadic Medullary Thyroid Carcinoma
Authors' conclusion
We confirmed the usefulness of IMTCGS in predicting DSS, LRFS, and DMFS. However, it finds the best utility in patients with a lower risk of recurrence and mortality, identifying those rare cases with more aggressive clinical behavior.
Study context
- Population
- Patients with sporadic medullary thyroid carcinoma (MTC) managed at Pisa University Hospital; localized 183/314 (58.3%), regional 100/314 (31.8%), distant 31/314 (9.9%) disease at diagnosissporadic MTC
- Participants
- 314 patients
- Exposure
- High-grade vs low-grade MTC by IMTCGS
- High-graden = 115
- Low-graden = 199reference
- Outcome
- DSS, DMFS and LRFS by IMTCGS grade
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
DSS, LRFS and DMFS
- High-grade vs Low-grade: P < 0.01
Observational data: associations, not effects.
Further findings
Preoperative calcitonin
P < 0.01
Tumor size
P < 0.01
Multifocality
P = 0.01
Minimal extrathyroidal extension
P < 0.01
Lymph node metastases
P < 0.01
Subgroups by disease extent at diagnosis
- Localized disease: significantly lower locoregional recurrence-free survival (LRFS) with high-grade vs low-grade
- Other subgroups: no difference in disease-specific survival (DSS), LRFS and distant metastasis-free survival (DMFS)
RET aggressive mutations subgroup
- No differences in DSS, LRFS and DMFS between high- and low-grade tumors
Original publication
The Usefulness of the International Grading System in the Management of Sporadic Medullary Thyroid Carcinoma. Thyroid. Published 11 February 2025. doi:10.
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