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Multicenter Study
. 2024 Aug;85(2):827-836.
doi: 10.1007/s12020-024-03897-y. Epub 2024 Jun 4.

The impact of preoperative calcitonin screening on the prognosis of patients with medullary thyroid cancer: a retrospective multicenter cohort study

Yingtong Hou #  1 , Yu Yang #  1 , Gang Chen #  2   3 , Jianyan Long #  4 , Yufei He #  1   5 , Dandan Xiong  2   3 , Yuyan Pang  2   3 , Qi Li  2   3 , Guojie Dong  6 , Siqi Qiao  6 , Wenke Chen  1 , Xuyang Li  1 , Jiayuan Zhang  1 , Tianyi Xu  1 , Xinwen Chen  1 , Fenghua Lai  1 , Haixia Guan  7 , Bo Lin  8 , Yihao Liu  9   10
Affiliations
Multicenter Study

The impact of preoperative calcitonin screening on the prognosis of patients with medullary thyroid cancer: a retrospective multicenter cohort study

Yingtong Hou et al. Endocrine. 2024 Aug.

Abstract

Purpose: There is still controversy in different guidelines regarding the necessity of routine preoperative calcitonin (Ctn) testing in medullary thyroid cancer (MTC). The level of preoperative Ctn may influence the extent of surgery.

Methods: This retrospective multicenter cohort study involved 149 MTC patients from 6 centers between 2013 to 2023. Clinical characteristics, surgical procedure and clinical outcomes were compared between Ctn-screened and Non-screened group. Kaplan-Meier method was used to estimate recurrence-free survival (RFS) and overall survival (OS).

Results: In total, 127 MTC patients with preoperative Ctn screening and 22 MTC patients without screening were analyzed. MTC patients with preoperative Ctn screening underwent more radical surgical procedures including total thyroidectomy and lymph node dissection, compared to those without screening (84.3% vs. 68.2% and 91.3% vs. 72.7%, respectively). The rate of recurrence and death were lower in the Ctn-screened group (16.1% vs. 36.4%, 0.8% vs. 18.2%, respectively). The survival curve showed a significantly better overall survival in Ctn-screened group than Non-screened group (HR:17.932, 95% CI 1.888-170.294, p-value = 0.001), while no significant difference was observed of RFS between two groups (HR:1.6, 95% CI 0.645-3.966, p-value = 0.307).

Conclusion: Preoperative Ctn screening can prompt surgeons choosing more radical initial surgical treatment for MTC patients, potentially leading to better long-term outcomes. Further evaluation of the cost-effectiveness of routine Ctn screening in thyroid nodule patients is warranted.

Keywords: Calcitonin screening; Medullary thyroid cancer; Prognosis.

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