Kinetic analysis of the growth rate of sporadic and hereditary medullary thyroid carcinoma: comparing the postoperative calcitonin-doubling rate with the hypothetical preoperative tumor volume-doubling rate.
Calcitonin
Doubling rate
Kinetic analysis of the growth rate
Medullary thyroid carcinoma
Tumor volume
Journal
Thyroid research
ISSN: 1756-6614
Titre abrégé: Thyroid Res
Pays: England
ID NLM: 101469037
Informations de publication
Date de publication:
2020
2020
Historique:
received:
10
05
2020
accepted:
08
07
2020
entrez:
24
7
2020
pubmed:
24
7
2020
medline:
24
7
2020
Statut:
epublish
Résumé
Our previous kinetic analyses of changes in the tumor volume (TV) of papillary thyroid microcarcinomas during active surveillance revealed that the tumors' growth varied over time from rather rapid growth to shrinkage and that the hypothetical TV-doubling rates (DRs) before the patients' presentation were much larger than their observed TV-DRs, indicating that rapid growth phases preceded their presentation. Whether this phenomenon also occurs in medullary thyroid carcinoma (MTC) was unknown. We retrospectively analyzed the cases of 46 MTC patients (18 hereditary, 28 sporadic; 9-80 years old at surgery, median 53.5 years; 19 males and 27 females) with elevated postoperative calcitonin (Ct) measured with the electrochemiluminescence immunoassay suggesting persistent disease. We calculated each patient's Ct-DR and his/her hypothetical TV-DR, using the tumor size and age at surgery. Ct-DRs (/year) after surgery were > 0.5, 0.1-0.5, - 0.1-0.1, and < - 0.1 in 9, 21, 12, and 4 patients, respectively (median 0.17). The hypothetical TV-DRs (/year) before surgery were > 1, 0.5-1.0, 0.1-0.5 and < 0.1 in 11, 21, 14, and 0 patients, respectively (median 0.60). The hypothetical TV-DR was higher than the observed Ct-DR in 41 of the 46 MTC patients and all 18 patients with hereditary MTC, suggesting that a rapid growth phase preceded surgery in these patients. In this series of MTC patients, the pre-surgery calculated hypothetical TV-DRs were significantly higher than the Ct-DRs observed post-surgery, suggesting that there were rapid growth periods before surgery in the vast majority of these MTC patients.
Sections du résumé
BACKGROUND
BACKGROUND
Our previous kinetic analyses of changes in the tumor volume (TV) of papillary thyroid microcarcinomas during active surveillance revealed that the tumors' growth varied over time from rather rapid growth to shrinkage and that the hypothetical TV-doubling rates (DRs) before the patients' presentation were much larger than their observed TV-DRs, indicating that rapid growth phases preceded their presentation. Whether this phenomenon also occurs in medullary thyroid carcinoma (MTC) was unknown.
METHODS
METHODS
We retrospectively analyzed the cases of 46 MTC patients (18 hereditary, 28 sporadic; 9-80 years old at surgery, median 53.5 years; 19 males and 27 females) with elevated postoperative calcitonin (Ct) measured with the electrochemiluminescence immunoassay suggesting persistent disease. We calculated each patient's Ct-DR and his/her hypothetical TV-DR, using the tumor size and age at surgery.
RESULTS
RESULTS
Ct-DRs (/year) after surgery were > 0.5, 0.1-0.5, - 0.1-0.1, and < - 0.1 in 9, 21, 12, and 4 patients, respectively (median 0.17). The hypothetical TV-DRs (/year) before surgery were > 1, 0.5-1.0, 0.1-0.5 and < 0.1 in 11, 21, 14, and 0 patients, respectively (median 0.60). The hypothetical TV-DR was higher than the observed Ct-DR in 41 of the 46 MTC patients and all 18 patients with hereditary MTC, suggesting that a rapid growth phase preceded surgery in these patients.
CONCLUSIONS
CONCLUSIONS
In this series of MTC patients, the pre-surgery calculated hypothetical TV-DRs were significantly higher than the Ct-DRs observed post-surgery, suggesting that there were rapid growth periods before surgery in the vast majority of these MTC patients.
Identifiants
pubmed: 32699556
doi: 10.1186/s13044-020-00087-6
pii: 87
pmc: PMC7372786
doi:
Types de publication
Journal Article
Langues
eng
Pagination
13Informations de copyright
© The Author(s) 2020.
Déclaration de conflit d'intérêts
Competing interestsThe authors declare that they have no competing interests.
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