Clinical profile of medullary thyroid carcinoma: Audit from a tertiary care center in South India

• Published in: Indian journal of endocrinology and metabolism Vol. 24; no. 4; pp. 355 - 359
• Main Authors: Manjunath, P, Vadayath, Usha, Nair, Vasantha, Pavithran, Praveen, Bhavani, Nisha, Kumar, Harish, Abraham, Nithya, Menon, Arun, Narayanan, Prem
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-07-2020; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Carcinoma; Care and treatment; differentiated thyroid carcinoma; Medical records; medullary thyroid carcinoma; Metastasis; multiple endocrine neoplasia; Neuroendocrine tumors; Original; survival; Thyroid cancer; Thyroid diseases; India; Differentiated thyroid carcinoma; multiple endocrine neoplasia; medullary thyroid carcinoma; survival
• ISSN: 2230-8210; 2230-9500
• DOI: 10.4103/ijem.IJEM_329_20

Context: Medullary thyroid carcinoma (MTC), being an aggressive disease, requires meticulous follow-up and multidisciplinary management. The clinical presentation, management, outcome of MTC varies among different populations. Aims: An audit was conducted to evaluate the demography, clinical presentation, management, and outcome of MTC in a tertiary care center in South India. Settings and Design: A retrospective analysis was conducted of data from hospital records of patients with MTC treated at our center from 2004 to 2019. Statistical Analysis: All analyses were performed with SPSS software (version 16). Results: Among the 82 patients (M 42, F 40), mean age was 42.07 years (SD 14.5), 46 were operated at our center and 36, outside. Follow-up data were not available for all patients. Median duration of the disease was 36 months and median follow-up was 28 months. Lymphnode dissection was more common (37/46) in patients operated at our center than outside operated patients (17/36) (P < 0.01). At presentation, more than half of the patients had stage IV disease and 8 had distant metastases. Bone, lung, and liver were the common sites of metastases. Persistent hypercalcitoninemia >50 pg/mL was seen in 49.9%. Salvage surgeries of the neck were necessary in 29 patients (38.2%). Mean survival was 66 months and 10-year survival was 35%. Male gender (P = 0.008) and Stage IV disease at presentation (P = 0.038) were associated with poorer survival. Conclusion: MTC, in our population, presented at an advanced stage. Male gender and stage IV at presentation had poor survival. Early diagnosis, aggressive initial neck clearance, close follow-up with tumor markers, appropriate imaging, along with prompt surgical intervention will help to improve outcome.