Table 1.
Clinical and histopathological data related to preoperative calcitonin in 94 MTC patients1 surgically treated in 2003–2016
| Total | Serum calcitonin before surgery (median) [range], pmol/L |
P value | |||||
|---|---|---|---|---|---|---|---|
| ≤20 (4.7) [1.1–20] | 21–500 (152) [23–474] | 501–1,000 (790) [528–1,000] | 1,001-3,000 (1,650) [1,020–2,450] | >3,000 (4,878) [3,010–9,890] | |||
| Patients (total),n | 13 | 37 | 16 | 19 | 9 | ||
| Gender | |||||||
| Female | 8 (62%) | 22 (59%) | 10 (63%) | 11 (58%) | 2 (22%) | 0.307 | |
| Male | 5 (38%) | 15 (41%) | 6 (37%) | 8 (42%) | 7 (78%) | ||
| Median age at thyroid surgery, years | 50 | 58 | 56 | 62 | 53 | 0.317 | |
| Range | 6–72 | 13–82 | 28–79 | 32–83 | 16–81 | ||
| Ultrasound of the neck performed | |||||||
| before primary surgery | 13 (100%) | 37 (100%) | 16 (100%) | 19 (100%) | 9 (100%) | N/A | |
| Primary surgery | |||||||
| Lobectomy ± ipsilateral CND/LND2 | 1 (8%) | 4 (11%) | 2 (12.5%) | 2 (10.5%) | 1 (11%) | ||
| TT | 2 (15%) | 0 | 0 | 0 | 0 | <0.001 | |
| TT + CND | 9 (69%) | 23 (62%) | 4 (15%) | 6 (31.5%) | 0 | ||
| TT + CND + LND | 1 (8%) | 10 (27%) | 10 (62.5%) | 11 (58%) | 8 (89%) | ||
| Surgical procedures | |||||||
| 1 | 12 (92%) | 35 (95%) | 11 (69%) | 12 (63%) | 5 (56%) | 0.007 | |
| ≥2 | 1 (8%) | 2 (5%) | 5 (31%) | 7 (37%) | 4 (44%) | ||
| Tumor diameter, mm | |||||||
| Available data,n | 90 | 12 | 36 | 15 | 18 | 9 | |
| Median [range] | 2.8 [1–33] | 17 [3–78] | 23 [4–58] | 35 [5–80] | 50 [23–125] | <0.001 | |
| Extrathyroidal extension | |||||||
| Available data,n | 91 | 12 | 37 | 15 | 18 | 9 | |
| Not present | 11 (92%) | 28 (76%) | 8 (53%) | 9 (50%) | 1 (11%) | ||
| Minimal/muscle/soft tissue | 1 (8%) | 8 (22.5%) | 7 (47%) | 6 (33%) | 4 (44.5%) | <0.001 | |
| Esophagus/larynx/vessel/nerve | 0 | 1 (2.5%) | 0 | 3 (17%) | 4 (44.5%) | ||
| Nodal status at primary surgery | |||||||
| pN0 | 10 (77%)3 | 24 (25%) | 3 (19%) | 4 (21%) | 0 | ||
| pN1a | 2 (15%) | 6 (16%) | 5 (31%) | 4 (21%) | 0 | <0.001 | |
| pN1b ipsilateral | 1 (8%) | 5 (13.5%) | 5 (31%) | 9 (47%) | 5 (66%) | ||
| pN1b bilateral | 0 | 2 (5.5%) | 3 (19%) | 2 (11%) | 4 (44%) | ||
| Metastatic lymph nodes | |||||||
| Available data,n | 88 | 10 | 37 | 14 | 18 | 9 | |
| Median [range] | 0 [0–13] | 0 [0–21] | 4 [0–36] | 8 [0–34] | 22 [9–43] | <0.001 | |
| Metastatic status at primary surgery | |||||||
| Available data,n | 82 | 13 | 32 | 13 | 16 | 8 | |
| M0 | 13 (100%) | 30 (94%) | 12 (92%) | 15 (94%) | 4 (50%) | 0.002 | |
| M1 | 0 | 2 (6%) | 1 (8%) | 1 (6%) | 4 (50%) | ||
| Stage at primary surgery4 | |||||||
| Available data,n | 87 | 13 | 32 | 15 | 18 | 9 | |
| I | 10 (77%) | 17 (53%) | 0 | 1 (5.5%) | 0 | ||
| II | 0 | 4 (13%) | 3 (20%) | 3 (17%) | 0 | <0.001 | |
| III | 2 (15%) | 3 (9%) | 4 (27%) | 2 (11%) | 0 | ||
| IV | 1 (8%) | 8 (25%) | 8 (53%) | 12 (66.5%) | 9 (100%) | ||
| Biochemical cure7 | |||||||
| Postoperatively | 12 (92%) | 22 (61%)5 | 5 (33%) | 5 (26%) | 1 (11%) | <0.001 | |
| Latest MTC-specific follow-up | 10 (77%) | 20 (56%)5 | 3 (20%) | 5 (26%)6 | 0 | <0.001 | |
| Died of MTC | 1 (8%) | 4 (11%) | 0 | 1 (5%) | 3 (33%) | 0.088 | |
| MTC-specific follow-up, months | |||||||
| Median [range]7 | 74 [2–142] | 38 [1–119] | 50 [3–158] | 20 [2–134] | 29 [5–65] | 0.155 | |
TT, total thyroidectomy; CND, lymph node dissection in the central neck; LND, lymph node dissection in the lateral neck; N/A, not applicable.
Only patients with available data were included in the analysis.
CND ipsilateral in 9 patients and LND ipsilateral in 2 patients.
Three patients with no lymph node dissection (Nx) achieved biochemical cure after primary surgery (classified as pN0).
Unknown preoperative metastatic status (Mx) and no lymph node dissection (Nx) were classified as clinically no metastasis (M0) and no metastatic lymph nodes (pN0) in the patients who achieved biochemical cure after completed primary surgery.
Information about biochemical cure was not available in 1 patient.
One patient had calcitonin 0.4 pmol/L at the latest follow-up and included as biochemically cured.
Available data: n = 93.