Taking into account the T stage when evaluating patients with stage 4C medullary thyroid carcinoma (MTC) can ensure a better risk stratification is achieved, according to a new study published in Clinical Endocrinology.
Currently, the American Joint Committee on Cancer Tumor, Node, Metastasis staging system does not take into consideration the T stage when evaluating stage 4C MTC.
However, a recent study showed that the T stage is an independent prognostic factor for both overall survival and cancer-specific survival in differentiated thyroid cancers with distant metastasis. This suggests that stratifying patients with distant metastasis by T stage is still important.
Here, a team of researchers from China investigated the clinical outcomes and implications of the T stage on the prognosis of 204 patients with stage 4C MTC. They analyzed patients’ overall survival, cancer-specific survival, and the precise cause of MTC-induced death and evaluated potential risk factors including T stage, in overall survival and cancer-specific survival.
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The results showed that the 5- and 10-year overall survival rates of the patients were 31.8% and 17.1% respectively. The 5- and 10-year cancer-related survival rates on the other hand were 40.4% and 22.5%, respectively.
Patients with an earlier T stage showed better overall and cancer-specific survival and the presence of an advanced T stage was an independent prognostic factor for both overall survival and cancer-specific survival. Moreover, the rates of death due to MTC were comparable between patients with stage 4C MTC with primary or distant metastatic lesions.
The researchers concluded that the T stage may still have a significant prognostic effect even in patients with advanced MTC. “Thus, stratifying stage [4C] MTC patients by their T stage may be important,” they wrote. Stage 4C is the most advanced MTC stage where patients have distant metastasis to the lungs, liver, skeleton, or other organs, regardless of the tumor size and any lymph node involvement.
Yuting S, Genpeng L, Tao W, et al. Distant metastasis in medullary thyroid carcinoma: clinical outcomes and implications of T stage. Clin Endocrinol. Published online March 9, 2022. doi:10.1111/cen.14717