Demystifying the conundrum of medullary thyroid cancers and providing a brief review of literature.

Abstract

Background: The aim of this study was to evaluate the clinicopathological features, patterns of care, and the survival outcomes of patients with medullary thyroid cancers (MTCs) treated at our tertiary care center.

Methods: We conducted a retrospective analysis of all patients with a histological diagnosis of MTC and who had been treated at our tertiary care center from August 1, 1986 through November 31, 2019.

Results: MTC in 83 patients were managed in the said period and comprised 44 men and 39 women. The median age of the patient cohort was 45 years. Seventy-seven of 83 patients underwent upfront surgery that entailed a total thyroidectomy and a central compartment neck dissection and a lateral compartment neck dissection, as was deemed appropriate. The disease-free survival rates at 5, 10, and 20 years for the present study were 62%, 51%, and 46%, respectively, and the overall survival rates for the same periods were 85%, 80%, and 76%, respectively. A formal analysis of the various prognostic factors was made. In multivariate analysis, the factors that significantly influenced the disease-free survival included gender and lymph node ratio. Furthermore, on multivariate analysis, the factors that significantly influenced the overall survival included age and gender, with male patients and patients aged >55 years faring poorly.

Conclusion: Our study has clearly demonstrated the favorable long-term survival outcomes of patients with MTCs. Furthermore, the analysis of various prognostic factors adds to our understanding of the biology of this rare form of thyroid cancer.