Endocrine Abstracts

Background: Data regarding the effect of gender and age on medullary thyroid cancer (MTC) presentation and prognosis is limited. Although older age and male sex were found to correlate with poorer prognosis in some studies, this correlation may reflect differences in MTC presentation between sex and age groups, or a mixture of hereditary and sporadic MTC forms.

Objective: To evaluate the impact of age and sex on the presentation and outcomes of MTC.

Methods: Epidemiological and clinical data of MTC patients was extracted from a joint registry of four medical centers in Israel.

Results: The study included 193 MTC patients (106 females, age 48.9±18.6, median 51), who were followed for 10.1±9.4 years. Female gender was associated with smaller tumor diameter (22.3 vs 28.7 mm, P=0.032), lower rate of lymph nodes involvement (42/70, 60% vs 49/64, 76.6%, P=0.044) and lower rate of distant metastases (11/87, 12.6% vs 23/75, 30.7%, P=0.007). Although females achieved higher cure rates (47/97, 48.5% vs 20/72, 27.8%, P=0.007), disease related mortality and all cause mortality did not differ between the genders. Patients aged <45 year at diagnosis had higher rates of hereditary familial forms of MTC (32/74, 43.2% vs 3/114, 2.6% .4%, P<0.0001). Analysis of the sporadic MTC cases (n=137) revealed that younger age at presentation was associated with higher number of metastatic lymph nodes (19.7±23.5 vs 10.2±9.3, P=0.05) and more therapeutic interventions during the follow-up (62.9% vs 33.7%, P=0.04). However, cure rate and disease related mortality were similar between the age groups.

Conclusions: In concert with previous literature, female MTC patients present with milder disease and achieve higher cure rates than males. However, younger age in the sporadic MTC form is associated with more advanced disease at presentation. Neither age nor gender affected disease related mortality.