The Health Thread

MYELOstudy: lymph node stage of aggressiveness in medullary thyroid cancer-a retrospective multi-center study analysis.

Researchers

Theodossis Papavramidis, Angeliki Chorti, Sohail Bakkar, Marco Raffaelli, Andro Košec, Van Trung Hoang, James Y Lim, Volkan Genc, Michele N Minuto, Pietro Giorgio Calò, Andrzej Hellmann, Giacomo Di Filippo, Lampros Karakozis, Alexandra Chrisoulidou, Viyey Kishore Doulatram Gamgaram, Chutintorn Sriphrapradang, Jean-Christophe Leclère, Aida Orois, Demarchi Marco, Muthuswamy Dhiwakar, Loredana de Pasquale, Antoine Buemi, Cédric Nesti, Rumen Pandev, Andres Chala, Selen Soylu Yalıman, Jiannis Hajiioannou, Shirley Yuk-Wah Liu, Sergii Cherenko, Nikolaos Voloudakis, Ioannis Koutelidakis, Konstantinos Nastos, Ramacciotti Constanza, Chiara Dobrinja, Maximilian Brunner, Lovenish Bains, Ramakanth Bhargav Panchangam, Fábio Muradás Girardi, Akif Enes Arikan, Hadj Omar El Malki, Michael de Cillia, Luigi Oragano, Ioannis Pliakos, Moysis Moysidis, Francesco Pennestrì, Carmela De Crea, Mateo Čukman, Andro Tarle, Olga S Senashova, Maisie L Shindo, İlgiz Tüzken, Mustafa Anil Turhan, Emanuela Varaldo, Manuela Albertelli, Fabio Medas, Gian Luigi Canu, Federico Cappellacci, Maciej Śledziński, Giovanni Lazzari, Eleonora Morelli, Stavros Karakozis, Maria Boudina, Michael Katsamakas, Marta Iturregui Guevara, Rangsima Aroonroch, Martí Manyalich, Oscar Vidal, Frederic Triponez, Nathalie Masse, Lokesh Kathirvel, Rajeshwari Muthusamy, Paula La Rubia, Luca Castellani, Burlacu Maria-Cristina, Furnica Raluca-Maria, Reto Kaderli, Serkan Teksoz, Tom Chi-Man Chow, Man Sze Lai, Liuchiia Shchekaturova, Evangelia Bellou, Maria Banus, Roxana Da Milano, Manuela Mastronardi, Robert Grützmann, Luiz Alberto Hauth, Aliende Lengler Abentroth, Onur Dulgeroglu, Cihan Uras, Giuseppe Placentino, Monica Leutner

Abstract

Medullary thyroid carcinoma (MTC) is a rare, but biologically aggressive cancer that accounts for 1-2% of all thyroid malignancies. Its aggressiveness has been linked to distinct clinicopathological features. Novel pathological predictors of aggressiveness have also been described in the literature. However, these remain contentious, to date. To assess the prognosticators of aggressiveness for MTC and establish potentially novel ones. The primary endpoint was to establish predictors for central and/or lateral cervical nodal metastatic disease. Whereas secondary endpoints include defining biochemical and histopathologic markers of aggressiveness. A multi-center retrospective analysis of prognosticators of aggressiveness in MTC. 785 patients with MTC were enrolled. The mean age was 56 years with a female to male ratio of 1: 1.7. Regression analysis demonstrated that aggressive prognosticator predictive of nodal metastasis included: age, pre- and post-operative Calcitonin and CEA levels, tumor size, multifocality, capsular and lymphovascular invasion, the presence of extrathyroidal extension, Ki-67, and RET positivity, desmoplasia, and inflammatory scores. This study provides an expanded spectrum of prognosticators of tumor aggressiveness. Furthermore, it also highlights the potential meaningful therapeutic implications of preoperative inflammatory scores, tumor desmoplastic reaction, and metastatic nodal ratio.