ECE2016 Eposter Presentations Thyroid cancer (81 abstracts)
Clinical usefulness of dynamic risk stratification in medullary thyroid cancer
Ji Min Han 1 , Hyemi Kwon 2 , Won Gu Kim 2 , Min Ji Jeon 2 , Tae Yong Kim 2 , Won Bae Kim 2 & Young Kee Shong 2
1Samsung Changwon Hospital, Changwon, Republic of Korea; 2Asan Medical Center, Seoul, Republic of Korea.
Purpose: To detect persistent/recurrent disease of medullary thyroid carcinoma (MTC) after initial surgery is important. The Tumor-Node-Metastasis (TNM) staging system is useful for predicting disease-specific mortality, but it is static and does not include postoperative serum calcitonin levels. We focused on the clinical usefulness of dynamic risk stratification (DRS) using the best response to initial therapy in patients with MTC.
Methods: A total of 120 MTC patients were classified into 3 DRS groups based on the response to initial therapy. The clinical outcomes were assessed according to the TNM staging and DRS.
Results: In DRS, 70%, 23%, and 7% of patients were classified into excellent, biochemical incomplete, and structural incomplete response group. In TNM staging, 37%, 16%, 13%, and 35% of patients were stage I, II, II, and IV, respectively. There were significant differences in survivals according to the TNM staging (P=0.03) and the DRS groups (P=0.005). During median 6.2 years of follow-up, 75 patients (63%) were no evidence of disease (NED). About 60% and 17% of patients in stage III and IV were NED, respectively. DRS could predict NED better than TNM staging according to PVE (49.1% vs. 28.7%, respectively). At final follow-up, 88%, 4%, and 0% attained NED in excellent, biochemical incomplete, and structural incomplete response group, respectively.
Conclusions: DRS based on the best response to the initial therapy could provide useful prognostic information in addition to initial TNM staging for prediction of mortality, as well as the likelihood of NED in patients with MTC.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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