title: Factors affecting long-term survival of Taiwanese patients with medullary thyroid carcinoma.
abstract: OBJECTIVE
  Long-term survival of patients with postoperative recurrence of medullary thyroid carcinoma (MTC) is not uncommon. This study assessed whether local or distant recurrence after operation is a significant factor affecting long-term survival in Taiwanese patients with MTC. The benefit of family screening for MTC patients on survival was also evaluated.
  
  
  METHODS
  A total of 54 patients with a diagnosis of MTC by pathology or cytology during the period from 1977 to 2000 were included in the study. Survival curves were compared between different groups according to age, gender, tumor size, metastasis, recurrence after surgical intervention, or diagnosis before and after the performance of family screening for MTC patients.
  
  
  RESULTS
  The 5-year survival rate using the Kaplan-Meier method was 84.1% (95% confidence interval, 73.9% to 94.2%), and the 10-year survival rate was 77.6% (95% confidence interval, 64.9% to 90.3%). Patients with lymph node metastasis and distant metastasis before operation had significantly shorter survival. Surprisingly, recurrence was not associated with shorter survival. Patients diagnosed after the start of family screening in 1991 had fewer lymph node metastases before operation, and lived longer.
  
  
  CONCLUSIONS
  Patients with lymph node or distant metastasis before operation had poor prognosis. However, local or distant recurrence after operation did not influence survival. Efforts to obtain early diagnosis and surgical intervention before tumor metastasis, such as family screening, resulted in improved survival.
authors.affiliation: Department of Internal Medicine, Far-Eastern Memorial Hospital, Taipei Hsien, Taiwan.
authors.forename: Mei-Hsiu
authors.initials: MH
authors.lastname: Chen
authors.forename: Ching-Chung
authors.initials: CC
authors.lastname: Chang
authors.forename: Tien-Shang
authors.initials: TS
authors.lastname: Huang
authors.forename: Keh-Sung
authors.initials: KS
authors.lastname: Tsai
authors.forename: Ming-Hong
authors.initials: MH
authors.lastname: Chen
authors.forename: Shih-Horng
authors.initials: SH
authors.lastname: Huang
authors.forename: Tien-Chun
authors.initials: TC
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018276:Carcinoma, Medullary / Q000175:diagnosis / Q000401:mortality*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000401:mortality*