Nodal disease burden and outcome of medullary thyroid carcinoma. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Medullary thyroid carcinoma (MTC) is a rare malignancy with high incidence of cervical lymph node (CLN) metastasis. We investigated the impact of nodal disease burden on survival. METHODS: We searched the National Cancer Database for MTC patients treated surgically. Impact of nodal metastasis on survival was analyzed using Cox univariable and multivariable regression. RESULTS: We identified 2627 patients from 2004 to 2015. Positive CLNs were identified in 1433 (54.5%), and 542 (20.6%) had >10 CLN+. Overall survival was 94.5% and 89.6% at 3 and 5 years. Patients with 11 to 20 CLN+ had significantly worse survival than patients with 1 to 10 CLN+ in univariable and multivariable analyses (HR = 3.56 (2.31-5.50) vs 2.26 (1.60-3.20); P < .0001). The ratio of positive to dissected CLN was associated with overall survival. CONCLUSIONS: Higher burden of nodal disease is associated with worse survival in MTC. The number of positive nodes could be a valuable prognosticator in addition to the current staging system.

publication date

  • October 27, 2020

Research

keywords

  • Carcinoma, Neuroendocrine
  • Thyroid Neoplasms

Identity

PubMed Central ID

  • PMC8414417

Scopus Document Identifier

  • 85093974721

Digital Object Identifier (DOI)

  • 10.1002/hed.26511

PubMed ID

  • 33107153

Additional Document Info

volume

  • 43

issue

  • 2