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Review
. 2022 Jul 22;15(1):12.
doi: 10.1186/s13044-022-00130-8.

Sporadic medullary thyroid cancer: a systematic review and meta-analysis of clinico-pathological and mutational characteristics predicting recurrence

Benjamin Cosway  1 , Jonathan Fussey  2 , Dae Kim  3 , James Wykes  4 , Michael Elliott  4 , Joel Smith  5
Affiliations
Review

Sporadic medullary thyroid cancer: a systematic review and meta-analysis of clinico-pathological and mutational characteristics predicting recurrence

Benjamin Cosway et al. Thyroid Res. .

Abstract

Introduction: Sporadic medullary thyroid cancer accounts for 75% of all medullary thyroid cancers and presents at a more advanced disease stage than its hereditary counterparts. Yet there is little evidence to support risk stratification of patients according to risk of recurrence.

Methods: A systematic review and meta-analysis was performed investigating clinical and pathological factors that are associated with recurrent disease in patients with medullary thyroid cancer.

Results: 10 studies totalling 458 patients were included in the meta-analyses. T3 and T4 disease (OR 9.33 (95% CI 2.5 - 34.82) p = 0.0009.), AJCC stage III and IV disease (OR 13.34 (95% CI 2.9 - 60.3) p = 0.0008) and the presence of nodal disease (OR 7.28 (95% CI 7.2-43.3) p = 0.03) were all associated with recurrent disease. RET mutations (OR 0.08 (95% CI -0.03-0.19) p = 0.17) and RET 918 T mutations (OR 1.77 (95% CI 0.804.0) P = 0.17) were not associated with disease recurrence. It was not possible to pool data with respect to extrathyroidal extension, extracapsular extension, peri-neural and lymphovascular invasion and RAS mutations.

Conclusion: T3 and T4 disease, AJCC stage III and IV disease and the presence of nodal disease are associated with recurrent disease. The heterogeneous reporting of recurrence and the lack of individual patient data precludes larger scale meta-analyses. Future research in this area should involve collaboration to establish standardised definitions of disease recurrence.

Keywords: Recurrence; Sporadic medullary thyroid cancer; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Prisma flow chart
Fig. 2
Fig. 2
Pooled analysis of the impact of T-stage with respect to recurrence in sMTC
Fig. 3
Fig. 3
Pooled analysis of the impact of Nodal disease with respect to recurrence in sMTC
Fig. 4
Fig. 4
Pooled analysis of the impact of AJCC stage with respect to recurrence in sMTC
Fig. 5
Fig. 5
Pooled analysis of the impact of somatic RET mutation with respect to recurrence in sMTC
Fig. 6
Fig. 6
Pooled analysis of the impact of M918T with respect to recurrence in sMTC
See this image and copyright information in PMC

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