title: [Medullary carcinoma of the thyroid gland. Prognostic factors].
abstract: OBJECTIVE
  To analyze the clinical features and possible prognostic factors involved in the clinical course of a series of 26 patients with the diagnosis of thyroid medullar carcinoma (TMC).
  
  
  METHODS
  An analysis was made of the variables age, sex, clinical course to diagnosis, paraneoplastic manifestations (flush, diarrhoea), clinical type (sporadic, non-associated, familial MEN IIa associated TMC, familial MEN IIb associated TMC), histologic uni or multicentricity, and stage of disease as possible predictive factors for the evolution.
  
  
  RESULTS
  The most remarkable prognostic factor was tumoral stage. The likelihood of a patient diagnosed with stage I or II being free of metastatic disease was 1, 0.66 and 0.33 at 15, 16 and 17 years, respectively. In contrast, those patients in stage III at diagnosis had a likelihood of being free from metastasis 5 years after diagnosis and therapy of 0. With regard to sex, a better clinical course was observed among males than among females, statistically significant at 3 and 5, but not at 10 years. No statistical significance was reached with the other possible prognostic factors investigated.
  
  
  CONCLUSIONS
  Given the obvious influence of tumoral stage of disease on prognosis, an early access to medical attention is desirable for diagnosis and treatment of TMC, as well as an early detection of family cases by a screening test.
authors.affiliation: Sección de Endocrinología, Hospital Universitario Puerta del Mar. Cádiz.
authors.forename: I
authors.initials: I
authors.lastname: Gavilán
authors.forename: R
authors.initials: R
authors.lastname: Astorga
authors.forename: S
authors.initials: S
authors.lastname: Sasián
authors.forename: D
authors.initials: D
authors.lastname: Acosta
authors.forename: M
authors.initials: M
authors.lastname: Aguilar
authors.forename: A
authors.initials: A
authors.lastname: Leal
authors.forename: L
authors.initials: L
authors.lastname: Escobar
authors.forename: J A
authors.initials: JA
authors.lastname: Córdoba
authors.forename: J A
authors.initials: JA
authors.lastname: Girón
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018276:Carcinoma, Medullary / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018813:Multiple Endocrine Neoplasia Type 2a / Q000175:diagnosis / Q000473:pathology; D018814:Multiple Endocrine Neoplasia Type 2b / Q000175:diagnosis / Q000473:pathology; D009362:Neoplasm Metastasis; D011379:Prognosis; D012737:Sex Factors; D013961:Thyroid Gland / Q000473:pathology; D013964:Thyroid Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D013997:Time Factors
vernacular_title: Carcinoma medular de tiroides. Factores pronósticos.