Endocrine Abstracts

The medical and social significance of the Multiple Endocrine Neoplasia type 2 (MEN2) is due to the severity of the manifestations of the disease components, namely the tumor process progression, a high risk of vascular accidents, pathological fractures of the femoral neck/spine, gastrointestinal bleeding, chronic renal failure. Late detection of pathology is associated with high mortality due to medullary thyroid cancer (MTC). Thus, the aim of the study was to establish the characteristics of the clinical course and management of patients with MTC.

Materials and methods: The study is carried out within the framework of the State Program ‘Oncological diseases’ on the task ‘To develop and implement effective technologies for the diagnostic detection and observation of patients with multiple endocrine neoplasia type 2A’. A retrospective analysis of patient data from 1987 to December 31, 2019 was performed. The information was obtained from the Cancer Register of the Republic of Belarus and the medical documentation of the Republican Center for Thyroid Tumors.

Results: A database of patients with MTC has been compiled containing information on 591 patients, of which 183 patients died. Currently included 420 (71.1%) women and 171 (28.9%) men. The average age at the time of diagnosis is 53.1 (43.2–61.8) years; 53.2 (43.7–62.6) years for women and 52.5 (41.6–59.4) for men (U = 32944, P = 0.115). In general, 95.6% of cases (565 people) underwent surgical treatment, 32.9% (195 people) radiation therapy and 25.9% (153 people) chemotherapy. Given the severity of the disease and the progression of the tumor process, 14.7% of patients (87 people) had combined surgical, chemotherapeutic and radiation treatments. 10.0% of patients (59 people) were operated and had chemotherapy, 17.2% of patients (102 people) had combined treatment – surgical and radiation therapy. Only surgical treatment was performed in 53.6% (317 patients). Less than one percent had only chemotherapy (4 people), only radiation therapy (3 people), complex radiation and chemotherapy treatment. 16 patients (2.7%) didn’t receive radical therapy. In this group the average life expectancy after diagnosis was 0.3 (0.7–0.03) years.

Conclusions: In the Republic of Belarus, surgical treatment is the preferred method for the radical treatment of medullary thyroid cancer. However, a high percentage of combined treatment requires optimization of the early diagnosis of medullary thyroid cancer.