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

期刊论文
发表日期：

2024年4月3日

查看全文

Sayid Shafi Zuhur,
Beyza Olcay Ozturk,
Umran Keskin,
Serhat Uysal,
Aysa Hacioglu,
Ugur Avci,
Seda Karsli,
Burak Andac,
Umit Nur Ozbay,
Faruk Kilinc,
Selvinaz Erol,
Merve Catak,
Hulyanur Sodan,
Zafer Pekkolay,
Sebnem Burhan,
Gulhan Akbaba,
Coskun Ates,
Goknur Yorulmaz,
Sakin Tekin,
Birol Topcu,
Mazhar Muslum Tuna,
Pinar Kadioglu,
Mustafa Sait Gonen,
Zuleyha Karaca,
Sema Ciftci,
Mehmet Celik,
Sibel Guldiken,
Dilek Tuzun,
Yuksel Altuntas,
Mujde Akturk,
Mutlu Niyazoglu,
Nese Cinar,
Ozen Oz Gul,
Medine Nur Kebapci,
Aysen Akalin,
Taner Bayraktaroglu,
Gulsah Elbuken

摘要

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.