ECE2016 Eposter Presentations Thyroid cancer (81 abstracts)
Medullary thyroid cancer (MTC): descriptive analysis and prognostic factors in a multicenter study
Victoria Alcazar 1 , Concepcion Blanco 2 , Cristina Alvarez-Escola 3 , Guadalupe Guijarro 4 , Javier Estrada 5 , Paz De Miguel 6 , Nuria Palacios 5 , Alejandra Duran 6 , M. Carmen Montañes 6 , Ainhoa Abad 5 , Beatriz Lecumberri 3 , Soralla Civantos 7 & Javier Aller 5
1Hospital Universitario Severo Ochoa, Madrid, Spain; 2Hospital Universitario Principe de Asturias, Madrid, Spain; 3Hospital Universitario La Paz, Madrid, Spain; 4Hospital Universitario Getafe, Madrid, Spain; 5Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain; 6Hospital Universitario Clinico San Carlos, Madrid, Spain; 7Hospital Universitario Fuenlabrada, Madrid, Spain.
Introduction: MTC accounts for 5% of thyroid cancers and can occur sporadically or as part of the multiple endocrine neoplasia type 2 syndrome (MEN 2). The objective of our study is to evaluate the prognostic factors and outcomes of patients with MTC in the community setting.
Methods: Retrospective descriptive multicenter study of patients with histological diagnosis of MTC. Descriptive, bivariate analyses (Student t for cuantitative and X2 test for cualitative variables) and logistic regression with SPSS 19.0 were performed.
Results: 102 patients were included (62% females). Median age at diagnosis: 45±16 years. Mean follow-up: 8 years. RET proto-oncogene mutations were found in 52% mainly in codon 634 (24.5%). Average basal calcitonin was 1497±3521 (median 402 pg/ml) and CEA 66±130 ng/ml. All cases underwent total thyroidectomy, with cervical lymphadenectomy in 64 cases (63%). Stage after surgery was I: 39%, II: 13%, III: 14% and IV: 34%. Residual disease was found in 44.5% (40% biochemical evidence of disease, 36% loco-regional metastasis and 24% distant metastasis). They were treated with additional surgery (44%), radiotherapy (11%) and/or tyrosinkinase inhibitors (13%). At the end of the follow up, 48% patients remained free of disease, 9% had calcitonin/CEA levels elevated without disease location, 8% had locorregional disease and 8% distant metastasis; 5 patients died because of MTC. On bivariate analysis, absence of cromogranin A staining, stage, local invasion, male sex, size, presurgery calcitonin levels were statistically significant predictors of residual disease after surgery whereas local invasion, stage, size, pre and postsurgery calcitonin and postsurgery CEA levels predicted persistent disease at the end of follow-up. Stage remained the only statistically significant indicator of both residual disease after surgery and persistent disease at last follow up on logistic regression analysis.
Conclusions: Only staging was significantly associated with persistent disease after surgery and at the end of follow-up.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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