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• W2078797905 abstract "In Brief Objective: This institutional study aimed at quantifying a medullary thyroid cancer (MTC) patient's risk of lung, liver, or bone metastasis. Background: Without quantitative information regarding risk factors for lung, liver, and bone metastasis, risk stratification is liable to be haphazard, resulting in poor cost-effectiveness of screening programs. Methods: Included in this study were 715 patients with MTC for whom histopathologic information was available for each lymph node removed. Results: Seventy-two patients (10.1%) were diagnosed with lung metastasis, 58 patients (8.1%) with liver metastasis, and 34 patients (4.8%) with bone metastasis. Multivariate analyses were limited to patients revealing no more than 1 type of distant metastasis to avoid confounding by other distant metastasis. Extrathyroidal extension and 1 to 10 involved nodes indicated a small risk of lung metastasis [3%–4%; odds ratio (OR) 3–4], tumors greater than 40 mm and 11 to 20 involved nodes implied an intermediate risk (13%; OR 6), and more than 20 involved nodes entailed a high risk (26%–30%; OR 14–16). In the multivariate logistic regressions on liver and bone metastasis, in which the number of involved nodes was omitted on statistic grounds, extrathyroidal extension signified a strong risk of liver metastasis (19%, OR 23), whereas no clinical-pathologic variables were significantly associated with bone metastasis. Cumulative rates of lung, liver, and bone metastasis, plotted against the number of lymph node metastases, were similar. Discussion: N categories encompassing 1 to 10 (N1), 11 to 20 (N2), and more than 20 (N3) lymph node metastases are important prognostic classifiers that should be incorporated into MTC staging systems for better risk stratification. In medullary thyroid cancer, there were 3 risk categories for lung metastasis: small risk (extrathyroidal extension and 1–10 involved nodes), intermediate risk (tumors >40 mm and 11–20 involved nodes), and high risk (>20 involved nodes). N categories encompassing 1 to 10 (N1), 11 to 20 (N2), and more than 20 (N3) node metastases hence may be suitable determinants of outcome." @default.
• W2078797905 created "2016-06-24" @default.
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• W2078797905 date "2013-02-01" @default.
• W2078797905 modified "2023-10-11" @default.
• W2078797905 title "Prognostic Impact of N Staging in 715 Medullary Thyroid Cancer Patients" @default.
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• W2078797905 doi "https://doi.org/10.1097/sla.0b013e318268301d" @default.
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