Medullary thyroid cancer (MTC): Risk Factors for Recurrence and Prognostic Variables that Influence Outcome

Amin, Ayman A.; Hussein, Hamdy Mohamed; Fekry, Ahmed K.; Mubarak, Mohamed

doi:10.21608/svuijm.2024.325670.1991

Medullary thyroid cancer (MTC): Risk Factors for Recurrence and Prognostic Variables that Influence Outcome

Document Type : Original research articles

Authors

¹ Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt

² General Surgery Department, Faculty of Medicine, Luxor University, Luxor, Egypt.

³ General Surgery Department, Faculty of Medicine, South Valley University, Qena, Egypt.

10.21608/svuijm.2024.325670.1991

Abstract

Background: Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor from thyroid C cells that can cause thyroid lumps or metastases. MTC accounts for 10.5% of metastasized thyroid tumors and is linked to RET proto-oncogene mutations. Surgery is the major therapy, although it's invasive and hard to cure.
Objectives: to review a contemporary institutional experience with medullary thyroid carcinoma treatment with two goals: to study the risk factors for recurrence and to identify prognostic factors that affect survival
Patients and methods: The National Cancer Institute (NCI) and Shefaa El Orman Oncology Hospital in Egypt studied 78 medullary thyroid cancer (MTC) patients during 2015-2022. It excluded unsuitable or missing pathology findings from retrospective and prospective studies. Imaging, blood testing, and fine-needle aspiration cytology were done. Total thyroidectomy and neck dissection were given depending on the diagnosis. Pathology and serum indicators were evaluated for recurrence after surgery. Inherited RET mutation patients had prophylactic thyroidectomy.
Results: The research comprised 78 patients (mean age: 43.13 ± 16.35 years; 41.03% male, 58.97% female). Diabetes (14.1%), hypertension (12.82%), and heart diseases (11.54%) were comorbidities. Left-sided tumors (50.88% vs. 28.57%) and bigger tumors (3.72 cm vs. 2.36 cm) were more common in recurrence instances Recurrence patient lymphovascular invasion (68.42% vs. 23.81%), serum calcitonin (1424.61 vs. 204.48 pg./mL), and CEA levels (263.82 vs. 23.54 ng/mL) were substantially greater. Advanced tumor stages and severe disease characteristics were connected to recurrence.
Conclusion: Medullary thyroid cancer (MTC) recurrence risk variables included bigger tumor size, advanced TMN staging, extrathyroid extension, and increased preoperative calcitonin and CEA values. Improving patient outcomes requires extensive initial surgery and postoperative monitoring.

Keywords