Background Medullary thyroid carcinoma (MTC) is a malignant tumor with low incidence. Currently, most studies have focused on the prognostic risk factors of MTC, whatever, time kinetic and risk factors related to calcitonin normalization (CN) and biochemical persistence/recurrence (BP) are yet to be elucidated. Methods A retrospective study was conducted for 190 MTC patients. Risk factors related to calcitonin normalization (CN) and biochemical persistence/recurrence (BP) were analyzed. The predictors of calcitonin normalization time (CNT) and biochemical persistent/recurrent time (BPT) were identified. Further, the prognostic roles of CNT and BPT were also demonstrated. Results The 5- and 10-year DFS were 86.7% and 70.2%, respectively. The 5- and 10-year OS were 97.6% and 78.8%, respectively. CN was achieved in 120 (63.2%) patients, whereas BP was presented in 76 (40.0%) patients at the last follow up. After curative surgery, 39 (32.5%) and 106 (88.3%) patients achieved CN within 1 week and 1 month. All patients who failed to achieve CN turned to BP over time and 32/70 of them developed structural recurrence. The median time of CNT and BPT was 1 month (1 day to 84 months) and 6 month (3 day to 63months), respectively. LNR > 0.23 and male gender were independent predictors for CN and BP. LNR > 0.23 (Hazard ratio (HR), 0.24; 95% CI,0.13-0.46; P < 0.01) and male gender (HR, 0.65; 95% CI, 0.42-0.99; P = 0.045) were independent predictors for longer CNT. LNR > 0.23 (HR,5.10; 95% CI,2.15-12.11; P < 0.01) was still the strongest independent predictor followed by preoperative serum Ctn > 1400ng/L (HR,2.34; 95% CI,1.29-4.25; P = 0.005) for shorter BPT. In survival analysis, primary tumor size > 2 cm (HR, 5.81; 95% CI,2.20-15.38; P < 0.01), CNT > 1 month (HR, 5.69; 95% CI, 1.17-27.61; P = 0.031) and multifocality (HR, 3.10; 95% CI, 1.45-6.65; P = 0.004) were independent predictor of DFS. Conclusion Early changes of Ctn after curative surgery can predict the long-term risks of biochemical and structural recurrence, which provide a useful real-time prognostic information. LNR significantly affect the time kinetic of biochemical prognosis. Tumor burden and CNT play a crucial role in MTC survival, the intensity of follow-up must be tailored accordingly.
基金:
This work was funded by the National Natural Science Foundation of
China (grant numbers: 82372753, 82172821, 82103386, 82303871); Tianjin
Municipal Science and Technology Project (grant numbers: 19JCYBJC27400,
21JCZDJC00360); The Science &Technology Development Fund of Tianjin
Education Commission for Higher Education (2021ZD033), Tianjin Key Medical
Discipline (Specialty) Construction Project (TJYXZDXK-058B, TJYXZDXK-009 A)
and Tianjin Health Research Project (TJWJ2022XK024). The Medical and Health
Science and Technology Project of Shandong Province (202304011426). There
are no conflicts of interest and no competing financial interest exists for any
of the authors
第一作者机构:[1]Tianjin Med Univ Canc Inst & Hosp, Tianjins Clin Res Ctr Canc, Natl Clin Res Ctr Canc, Dept Thyroid & Neck Tumor,Key Lab Canc Prevent & T, Tianjin, Peoples R China[2]Binzhou Med Univ Hosp, Dept Thyroid & Breast Surg, Binzhou, Peoples R China
共同第一作者:
通讯作者:
通讯机构:[1]Tianjin Med Univ Canc Inst & Hosp, Tianjins Clin Res Ctr Canc, Natl Clin Res Ctr Canc, Dept Thyroid & Neck Tumor,Key Lab Canc Prevent & T, Tianjin, Peoples R China[5]Tianjin Union Med Ctr, Dept Thyroid & Breast Surg, Tianjin, Peoples R China[6]Tianjin Union Med Ctr, Tianjin Key Lab Gen Surg Construct, Tianjin, Peoples R China
推荐引用方式(GB/T 7714):
Guo Fengli,Fu Guiming,Li Fangxuan,et al.Time Kinetics and prognosis roles of calcitonin after surgery for medullary thyroid carcinoma[J].WORLD JOURNAL OF SURGICAL ONCOLOGY.2024,22(1):doi:10.1186/s12957-024-03397-3.
APA:
Guo, Fengli,Fu, Guiming,Li, Fangxuan,Hua, Yitong,Wang, Zhongyu...&Gao, Ming.(2024).Time Kinetics and prognosis roles of calcitonin after surgery for medullary thyroid carcinoma.WORLD JOURNAL OF SURGICAL ONCOLOGY,22,(1)
MLA:
Guo, Fengli,et al."Time Kinetics and prognosis roles of calcitonin after surgery for medullary thyroid carcinoma".WORLD JOURNAL OF SURGICAL ONCOLOGY 22..1(2024)