Disease-free survival and the prognostic factors affecting disease-free survival in patients with medullary thyroid carcinoma: a multicenter cohort study

Sayid Shafi Zuhur¹, Beyza Olcay Ozturk², Umran Keskin³, Serhat Uysal⁴, Aysa Hacioglu⁵, Ugur Avci⁶, Seda Karsli⁷, Burak Andac⁸, Umit Nur Ozbay⁹, Faruk Kilinc¹⁰, Selvinaz Erol¹¹, Merve Catak¹², Hulyanur Sodan¹³, Zafer Pekkolay¹⁴, Sebnem Burhan¹⁵, Gulhan Akbaba¹⁶, Coskun Ates¹⁷, Goknur Yorulmaz¹⁸, Sakin Tekin¹⁹, Birol Topcu²⁰, Mazhar Muslum Tuna³, Pinar Kadioglu⁴, Mustafa Sait Gonen⁴, Zuleyha Karaca⁵, Sema Ciftci⁷, Mehmet Celik⁸, Sibel Guldiken⁸, Dilek Tuzun⁹, Yuksel Altuntas¹¹, Mujde Akturk¹³, Mutlu Niyazoglu¹⁵, Nese Cinar¹⁶, Ozen Oz Gul¹⁷, Medine Nur Kebapci¹⁸, Aysen Akalin¹⁸, Taner Bayraktaroglu¹⁹, Gulsah Elbuken²

Affiliations

¹ Department of Endocrinology and Metabolism, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey. zuhur744@gmail.com.
² Department of Endocrinology and Metabolism, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey.
³ Department of Endocrinology and Metabolism, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey.
⁴ Department of Endocrinology and Metabolism, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
⁵ Department of Endocrinology and Metabolism, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
⁶ Department of Endocrinology and Metabolism, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
⁷ Department of Endocrinology and Metabolism, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
⁸ Department of Endocrinology and Metabolism, Faculty of Medicine, Trakya University, Edirne, Turkey.
⁹ Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
¹⁰ Department of Endocrinology and Metabolism, Faculty of Medicine, Fırat University, Elazig, Turkey.
¹¹ Department of Endocrinology and Metabolism, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
¹² Department of Endocrinology and Metabolism, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey.
¹³ Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey.
¹⁴ Department of Endocrinology and Metabolism, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
¹⁵ Department of Endocrinology and Metabolism, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
¹⁶ Department of Endocrinology and Metabolism, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
¹⁷ Department of Endocrinology and Metabolism, Faculty of Medicine, Uludag University, Bursa, Turkey.
¹⁸ Department of Endocrinology and Metabolism, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
¹⁹ Department of Endocrinology and Metabolism, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
²⁰ Department of Biostatistics, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey.

PMID: 38570387
DOI: 10.1007/s12020-024-03809-0

Multicenter Study

Disease-free survival and the prognostic factors affecting disease-free survival in patients with medullary thyroid carcinoma: a multicenter cohort study

Sayid Shafi Zuhur et al. Endocrine. 2024 Sep.

. 2024 Sep;85(3):1300-1309.

doi: 10.1007/s12020-024-03809-0. Epub 2024 Apr 3.

Authors

Affiliations

¹ Department of Endocrinology and Metabolism, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey. zuhur744@gmail.com.
² Department of Endocrinology and Metabolism, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey.
³ Department of Endocrinology and Metabolism, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkey.
⁴ Department of Endocrinology and Metabolism, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey.
⁵ Department of Endocrinology and Metabolism, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
⁶ Department of Endocrinology and Metabolism, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey.
⁷ Department of Endocrinology and Metabolism, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
⁸ Department of Endocrinology and Metabolism, Faculty of Medicine, Trakya University, Edirne, Turkey.
⁹ Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
¹⁰ Department of Endocrinology and Metabolism, Faculty of Medicine, Fırat University, Elazig, Turkey.
¹¹ Department of Endocrinology and Metabolism, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
¹² Department of Endocrinology and Metabolism, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey.
¹³ Department of Endocrinology and Metabolism, Faculty of Medicine, Gazi University, Ankara, Turkey.
¹⁴ Department of Endocrinology and Metabolism, Faculty of Medicine, Dicle University, Diyarbakir, Turkey.
¹⁵ Department of Endocrinology and Metabolism, Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey.
¹⁶ Department of Endocrinology and Metabolism, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey.
¹⁷ Department of Endocrinology and Metabolism, Faculty of Medicine, Uludag University, Bursa, Turkey.
¹⁸ Department of Endocrinology and Metabolism, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey.
¹⁹ Department of Endocrinology and Metabolism, Faculty of Medicine, Bulent Ecevit University, Zonguldak, Turkey.
²⁰ Department of Biostatistics, Faculty of Medicine, Tekirdag Namik Kemal University, Tekirdag, Turkey.

PMID: 38570387
DOI: 10.1007/s12020-024-03809-0

Abstract

Purpose: Despite several factors that may have been associated with poor disease-free survival (DFS) in patients with medullary thyroid carcinoma (MTC), only a few studies have evaluated the prognostic factors affecting DFS in MTC patients. Therefore, this study evaluated the prognostic factors affecting DFS, in a large number of patients with MTC.

Methods: Patients treated for MTC were retrospectively analyzed. Patients were stratified as having persistent/recurrent disease and no evidence of disease (NOD) at the last follow-up. The factors affecting DFS after the initial therapy and during the follow-up period were investigated.

Results: This study comprised 257 patients [females 160 (62.3%), hereditary disease 48 (18.7%), with a mean follow-up time of 66.8 ± 48.5 months]. Persistent/recurrent disease and NOD were observed in 131 (51%) and 126 (49%) patients, respectively. In multivariate analysis, age > 55 (HR: 1.65, p = 0.033), distant metastasis (HR: 2.41, p = 0.035), CTN doubling time (HR: 2.7, p = 0.031), and stage III vs. stage II disease (HR 3.02, p = 0.048) were independent predictors of persistent/recurrent disease. Although 9 (8%) patients with an excellent response after the initial therapy experienced a structural recurrence, the absence of an excellent response was the strongest predictor of persistent/recurrent disease (HR: 5.74, p < 0.001).

Conclusions: The absence of an excellent response after initial therapy is the strongest predictor of a worse DFS. However, a significant proportion of patients who achieve an excellent response could experience a structural recurrence. Therefore, careful follow-up of patients, including those achieving an excellent response is essential.

Keywords: Disease-free survival; Excellent response; Medullary thyroid carcinoma; Prognosis.

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References

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Disease-free survival and the prognostic factors affecting disease-free survival in patients with medullary thyroid carcinoma: a multicenter cohort study

Affiliations

Disease-free survival and the prognostic factors affecting disease-free survival in patients with medullary thyroid carcinoma: a multicenter cohort study

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Supplementary concepts

LinkOut - more resources

Full Text Sources

Medical