The impact of preoperative calcitonin screening on the prognosis of patients with medullary thyroid cancer: a retrospective multicenter cohort study
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 M...
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| Published in | Endocrine Vol. 85; no. 2; pp. 827 - 836 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
New York
Springer US
01.08.2024
Springer Nature B.V |
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| 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. |
|---|---|
| AbstractList | 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.PURPOSEThere 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.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).METHODSThis 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).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).RESULTSIn 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).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.CONCLUSIONPreoperative 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. 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. 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). 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). 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. 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. PurposeThere 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.MethodsThis 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).ResultsIn 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).ConclusionPreoperative 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. |
| Author | Chen, Wenke Long, Jianyan Li, Xuyang Li, Qi Dong, Guojie Guan, Haixia Yang, Yu Chen, Xinwen Zhang, Jiayuan Lai, Fenghua Xu, Tianyi Chen, Gang Liu, Yihao Pang, Yuyan Qiao, Siqi Lin, Bo He, Yufei Xiong, Dandan Hou, Yingtong |
| Author_xml | – sequence: 1 givenname: Yingtong surname: Hou fullname: Hou, Yingtong organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University – sequence: 2 givenname: Yu surname: Yang fullname: Yang, Yu organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University – sequence: 3 givenname: Gang surname: Chen fullname: Chen, Gang organization: Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumor Images, The First Affiliated Hospital of Guangxi Medical University – sequence: 4 givenname: Jianyan surname: Long fullname: Long, Jianyan organization: Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University – sequence: 5 givenname: Yufei surname: He fullname: He, Yufei organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Department of Oncology, The First Affiliated Hospital of Sun Yat-sen University – sequence: 6 givenname: Dandan surname: Xiong fullname: Xiong, Dandan organization: Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumor Images, The First Affiliated Hospital of Guangxi Medical University – sequence: 7 givenname: Yuyan surname: Pang fullname: Pang, Yuyan organization: Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumor Images, The First Affiliated Hospital of Guangxi Medical University – sequence: 8 givenname: Qi surname: Li fullname: Li, Qi organization: Department of Pathology, The First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region Engineering Research Center for Artificial Intelligence Analysis of Multimodal Tumor Images, The First Affiliated Hospital of Guangxi Medical University – sequence: 9 givenname: Guojie surname: Dong fullname: Dong, Guojie organization: Center for Information Technology & Statistics, The First Affiliated Hospital of Sun Yat-sen University – sequence: 10 givenname: Siqi surname: Qiao fullname: Qiao, Siqi organization: Center for Information Technology & Statistics, The First Affiliated Hospital of Sun Yat-sen University – sequence: 11 givenname: Wenke surname: Chen fullname: Chen, Wenke organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University – sequence: 12 givenname: Xuyang surname: Li fullname: Li, Xuyang organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University – sequence: 13 givenname: Jiayuan surname: Zhang fullname: Zhang, Jiayuan organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University – sequence: 14 givenname: Tianyi surname: Xu fullname: Xu, Tianyi organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University – sequence: 15 givenname: Xinwen surname: Chen fullname: Chen, Xinwen organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University – sequence: 16 givenname: Fenghua surname: Lai fullname: Lai, Fenghua organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University – sequence: 17 givenname: Haixia surname: Guan fullname: Guan, Haixia email: guanhaixia@gdph.org.cn organization: Department of Endocrinology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University – sequence: 18 givenname: Bo surname: Lin fullname: Lin, Bo email: liuyih3@mail2.sysu.edu.cn organization: Department of Thyroid Surgery, The First Affiliated Hospital of Sun Yat-sen University – sequence: 19 givenname: Yihao surname: Liu fullname: Liu, Yihao email: linbo29@mail2.sysu.edu.cn organization: Department of Endocrinology, The First Affiliated Hospital of Sun Yat-sen University, Clinical Trials Unit, The First Affiliated Hospital of Sun Yat-sen University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38834859$$D View this record in MEDLINE/PubMed |
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| Keywords | Calcitonin screening Medullary thyroid cancer Prognosis |
| Language | English |
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There is still controversy in different guidelines regarding the necessity of routine preoperative calcitonin (Ctn) testing in medullary thyroid cancer... There is still controversy in different guidelines regarding the necessity of routine preoperative calcitonin (Ctn) testing in medullary thyroid cancer (MTC).... PurposeThere is still controversy in different guidelines regarding the necessity of routine preoperative calcitonin (Ctn) testing in medullary thyroid cancer... |
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| SubjectTerms | Adult Aged Calcitonin Calcitonin - blood Carcinoma, Neuroendocrine - blood Carcinoma, Neuroendocrine - diagnosis Carcinoma, Neuroendocrine - mortality Carcinoma, Neuroendocrine - surgery Cohort analysis Diabetes Endocrinology Female Humanities and Social Sciences Humans Internal Medicine Lymph nodes Male Medical prognosis Medicine Medicine & Public Health Middle Aged multidisciplinary Original Article Patients Preoperative Care - methods Prognosis Retrospective Studies Science Survival Thyroid cancer Thyroid Neoplasms - blood Thyroid Neoplasms - diagnosis Thyroid Neoplasms - mortality Thyroid Neoplasms - surgery Thyroidectomy |
| Title | The impact of preoperative calcitonin screening on the prognosis of patients with medullary thyroid cancer: a retrospective multicenter cohort study |
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