Nodal Disease Burden and Outcome of Medullary Thyroid Carcinoma
| Autor: | Qianhui Shao, Luc G. T. Morris, Babak Givi, Jamie R Oliver, Kepal N. Patel, Lindsey E Moses, Janine M. Rotsides |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Oncology
medicine.medical_specialty Medullary cavity Malignancy Article Nodal disease Metastasis Thyroid carcinoma 03 medical and health sciences 0302 clinical medicine Cost of Illness Internal medicine Humans Medicine Thyroid Neoplasms Lymph node Neoplasm Staging business.industry Nodal metastasis Cancer Prognosis medicine.disease Carcinoma Neuroendocrine medicine.anatomical_structure Otorhinolaryngology Lymphatic Metastasis 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Surgery Lymph Nodes High incidence business |
| Zdroj: | Head Neck |
| ISSN: | 1072-7515 |
| DOI: | 10.1016/j.jamcollsurg.2019.08.185 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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