Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2017 Jan;161(1):137-146.
doi: 10.1016/j.surg.2016.04.053. Epub 2016 Nov 11.

Trends in the presentation, treatment, and survival of patients with medullary thyroid cancer over the past 30 years

Reese W Randle  1 , Courtney J Balentine  2 , Glen E Leverson  2 , Jeffrey A Havlena  2 , Rebecca S Sippel  2 , David F Schneider  2 , Susan C Pitt  2
Affiliations
Comparative Study

Trends in the presentation, treatment, and survival of patients with medullary thyroid cancer over the past 30 years

Reese W Randle et al. Surgery. 2017 Jan.

Abstract

Background: The impact of recent medical advances on disease presentation, extent of operation, and disease-specific survival for patients with medullary thyroid cancer is unclear.

Methods: We used the Surveillance, Epidemiology, and End Results registry to compare trends over 3 time periods, 1983-1992, 1993-2002, and 2003-2012.

Results: There were 2,940 patients diagnosed with medullary thyroid cancer between 1983 and 2012. The incidence of medullary thyroid cancer increased during this time period from 0.14 to 0.21 per 100,000 population, and mean age at diagnosis increased from 49.8 to 53.8 (P < .001). The proportion of tumors ≤1 cm also increased from 11.4% in 1983-1992, 19.6% in 1993-2002, to 25.1% in 2003-2012 (P < .001), but stage at diagnosis remained constant (P = .57). In addition, the proportion of patients undergoing a total thyroidectomy and lymph node dissection increased from 58.2% to 76.5% during the study period (P < .001). In the most recent time interval, 5-year, disease-specific survival improved from 86% to 89% in all patients (P < .001) but especially for patients with regional (82% to 91%, P = .003) and distant (40% to 51%, P = .02) disease.

Conclusion: These data demonstrate that the extent of operation is increasing for patients with medullary thyroid cancer. Disease-specific survival is also improving, primarily in patients with regional and distant disease.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Study Cohort Inclusion and Exclusion Flowchart
This diagram depicts how the final study cohort was defined.
Figure 2
Figure 2. Age-adjusted Incidence of Medullary Thyroid Cancer
The incidence of Medullary Thyroid Cancer increased overall (top) and across all stages of disease (bottom).
Figure 3
Figure 3. Trend in Lymph Node Dissections at the time of Total Thyroidectomy
This histogram demonstrates that the proportion of patients who underwent a total thyroidectomy with a lymph node dissection increased from 58.2% to 69.2% to 76.5% in the last 30 years (p < 0.001).
Figure 4
Figure 4. Disease Specific Survival for patients with Medullary Thyroid Cancer based on Time Interval
The four Kaplan-Meier survival curves demonstrate improved disease specific survival (DSS) for all patients (top left) and for those patients with regional (bottom left) and distant (bottom right) disease, but not with localized disease (top right).
See this image and copyright information in PMC

Comment in

  • Discussion.
    [No authors listed] [No authors listed] Surgery. 2017 Jan;161(1):145-146. doi: 10.1016/j.surg.2016.04.055. Epub 2016 Nov 11. Surgery. 2017. PMID: 27842917 No abstract available.

References

    1. Cramer JD, Fu P, Harth KC, Margevicius S, Wilhelm SM. Analysis of the rising incidence of thyroid cancer using the Surveillance, Epidemiology and End Results national cancer data registry. Surgery. 2010;148(6):1147–52. discussion 52-3. - PubMed
    1. Morris LG, Sikora AG, Tosteson TD, Davies L. The increasing incidence of thyroid cancer: the influence of access to care. Thyroid: official journal of the American Thyroid Association. 2013;23(7):885–91. - PMC - PubMed
    1. The American Cancer Society. Cancer Facts and Figures. 2015 www.cancer.org; 2015 [cited 2016 January 14]
    1. Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH. Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems. Cancer. 2000;88(5):1139–48. - PubMed
    1. Gilliland FD, Hunt WC, Morris DM, Key CR. Prognostic factors for thyroid carcinoma. A population-based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973–1991. Cancer. 1997;79(3):564–73. - PubMed

Publication types

MeSH terms

Supplementary concepts