Long-term Clinical Outcomes of Patients With Medullary Thyroid Cancer: A Single Institution, Tertiary Referral Centre Experience

IF 3.2 3区 医学 Q2 ONCOLOGY Clinical oncology Pub Date : 2024-11-08 DOI:10.1016/j.clon.2024.103686
K. Wong , L. Cheng , S. Forner , E. Kim , V. Johri , D. Morganstein , D. Kim , K. Newbold
{"title":"Long-term Clinical Outcomes of Patients With Medullary Thyroid Cancer: A Single Institution, Tertiary Referral Centre Experience","authors":"K. Wong ,&nbsp;L. Cheng ,&nbsp;S. Forner ,&nbsp;E. Kim ,&nbsp;V. Johri ,&nbsp;D. Morganstein ,&nbsp;D. Kim ,&nbsp;K. Newbold","doi":"10.1016/j.clon.2024.103686","DOIUrl":null,"url":null,"abstract":"<div><h3>Aims</h3><div>Medullary thyroid cancer (MTC) is a rare form of thyroid cancer with a variable disease course. We aimed to conduct a real-world analysis of the clinical outcomes of patients with MTC, thereby providing further insight into the prognosis and management.</div></div><div><h3>Materials and methods</h3><div>All patients with MTC whose data were available on electronic patient records since its introduction in 1992 at our institution were collected retrospectively. Data collected include patient characteristics, staging, treatment modalities and survival outcomes. The data extraction cut-off was 31st December 2022. Progression-free survival (PFS) and overall survival (OS) were analysed using Kaplan–Maier curves and log-rank test. The significance threshold was set at p value &lt;0.05.</div></div><div><h3>Results</h3><div>164 patients were included in this study. The median age at presentation was 44 years. Majority of patients (61%) presented with advanced disease; 41% were stage IVa, 4% IVb and 16% IVc. The 10-year OS was 92% for stage I-III disease, 77% for stage IVa/b and 38% for stage IVc. Germline rearranged during transfection <em>(RET)</em> mutations were detected in 21% of patients. 98% of patients received primary surgery and 24% received systemic treatment for recurrent/metastatic disease, with a high response rate seen with <em>RET-</em>specific inhibitors in those with <em>RET</em>-mutant MTC. Adjuvant radiotherapy improved locoregional control for those with locally advanced disease (p = 0.001) but failed to translate into OS benefit (p = 0.486).</div></div><div><h3>Conclusion</h3><div>Survival outcomes observed in our cohort mirror those reported in the literature and highlight the need for improved therapy options, especially in those presenting with metastatic disease. Our data reaffirmed a lack of survival benefit with adjuvant radiotherapy for MTC with a high rate of systemic relapse and future research should focus on evolving mechanisms of resistance to novel tyrosine kinase inhibitors.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"37 ","pages":"Article 103686"},"PeriodicalIF":3.2000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0936655524004825","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Aims

Medullary thyroid cancer (MTC) is a rare form of thyroid cancer with a variable disease course. We aimed to conduct a real-world analysis of the clinical outcomes of patients with MTC, thereby providing further insight into the prognosis and management.

Materials and methods

All patients with MTC whose data were available on electronic patient records since its introduction in 1992 at our institution were collected retrospectively. Data collected include patient characteristics, staging, treatment modalities and survival outcomes. The data extraction cut-off was 31st December 2022. Progression-free survival (PFS) and overall survival (OS) were analysed using Kaplan–Maier curves and log-rank test. The significance threshold was set at p value <0.05.

Results

164 patients were included in this study. The median age at presentation was 44 years. Majority of patients (61%) presented with advanced disease; 41% were stage IVa, 4% IVb and 16% IVc. The 10-year OS was 92% for stage I-III disease, 77% for stage IVa/b and 38% for stage IVc. Germline rearranged during transfection (RET) mutations were detected in 21% of patients. 98% of patients received primary surgery and 24% received systemic treatment for recurrent/metastatic disease, with a high response rate seen with RET-specific inhibitors in those with RET-mutant MTC. Adjuvant radiotherapy improved locoregional control for those with locally advanced disease (p = 0.001) but failed to translate into OS benefit (p = 0.486).

Conclusion

Survival outcomes observed in our cohort mirror those reported in the literature and highlight the need for improved therapy options, especially in those presenting with metastatic disease. Our data reaffirmed a lack of survival benefit with adjuvant radiotherapy for MTC with a high rate of systemic relapse and future research should focus on evolving mechanisms of resistance to novel tyrosine kinase inhibitors.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
甲状腺髓样癌患者的长期临床结果:单一机构,三级转诊中心经验
目的甲状腺髓样癌(MTC)是一种罕见的甲状腺癌,病程多变。我们的目的是对MTC患者的临床结果进行现实分析,从而进一步了解预后和管理。材料与方法回顾性收集我院1992年引进电子病历以来所有MTC患者资料。收集的数据包括患者特征、分期、治疗方式和生存结果。数据提取截止日期为2022年12月31日。采用Kaplan-Maier曲线和log-rank检验分析无进展生存期(PFS)和总生存期(OS)。显著性阈值设为p值<;0.05。结果164例患者纳入本研究。发病时的中位年龄为44岁。大多数患者(61%)表现为晚期疾病;IVa期41%,IVb期4%,IVc期16%。I-III期的10年OS为92%,IVa/b期为77%,IVc期为38%。21%的患者在转染期间检测到生殖系重排(RET)突变。98%的患者接受了原发性手术,24%的患者接受了复发/转移性疾病的全身治疗,在ret突变型MTC患者中使用ret特异性抑制剂的反应率很高。辅助放疗改善了局部晚期疾病患者的局部控制(p = 0.001),但未能转化为OS获益(p = 0.486)。结论:在我们的队列中观察到的生存结果与文献报道的结果一致,并强调了改进治疗方案的必要性,特别是对于那些出现转移性疾病的患者。我们的数据再次证实,辅助放疗对全身复发率高的MTC缺乏生存益处,未来的研究应侧重于对新型酪氨酸激酶抑制剂耐药的进化机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Clinical oncology
Clinical oncology 医学-肿瘤学
CiteScore
5.20
自引率
8.80%
发文量
332
审稿时长
40 days
期刊介绍: Clinical Oncology is an International cancer journal covering all aspects of the clinical management of cancer patients, reflecting a multidisciplinary approach to therapy. Papers, editorials and reviews are published on all types of malignant disease embracing, pathology, diagnosis and treatment, including radiotherapy, chemotherapy, surgery, combined modality treatment and palliative care. Research and review papers covering epidemiology, radiobiology, radiation physics, tumour biology, and immunology are also published, together with letters to the editor, case reports and book reviews.
期刊最新文献
Neoadjuvant Chemotherapy and Low Dose Immunotherapy in Resectable Non-small Cell Lung Cancer: A Multi-center Retrospective Cohort Analysis Management of Head and Neck Squamous Cell Carcinoma With N3 Nodal Disease RCR meetings YCLON Journals Advert 15 January 25_01 Mammary Mucoepidermoid Carcinomas: A Population-Based Analysis
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1