[Prognostic value of clinical, histopathological and immunohistochemical features in medullary thyroid cancer].
OBJECTIVE
To analyze the importance of various clinical, histopathological and immunohistochemical features in the prognosis of resected medullary thyroid carcinoma.


METHODS
A total of 55 cases of medullary thyroid carcinoma consecutively operated were investigated. The data referring to clinical features were collected in the patient's clinical history. The histopathological and immunohistochemical features of the tumors were taken from their pathological anatomy report.


RESULTS
Survival at one year was 96 ± 2%; at 5 years 91 ± 4%; at 10 years 88 ±6%; at 15 years 83 ± 7%; and at 20 years 61 ± 14%. Among epidemiological features, tumor type was significantly related with the disease (best familial prognosis; P=.035); among histopathological features, the presence of C cell hyperplasia and the presence of tumor necrosis had a significant relationship (P=.0005 and P=.039); among immunohistochemical features, positivity for p53 and for c-erb-b2 (P=.023 and P=.022); and finally, among staging data, TNM clinical staging (P=.015), size (P=.046) and the presence of distant metastases (P=.002). According to Cox's regression model, the only variables indicating a poor prognosis were: the existence of necrosis (P=.039; OR=6.513) and tumor size>4 cm (P=.027; OR=14.196).


CONCLUSIONS
The survival rate was mainly determined by tumor size and the presence of tumor necrosis. None of the immunohistochemical markers had a significant influence on survival.
Servicio de Cirugía General y del Aparato Digestivo I, CIBEREHD, Hospital Universitario Virgen de la Arrixaca, El Palmar, Murcia, España. ARZRIOS@teleline.es
Antonio
A
Ríos
José Manuel
JM
Rodríguez
Beatriz
B
Febrero
José Manuel
JM
Acosta
Nuria
N
Torregrosa
Pascual
P
Parrilla
D000328:Adult; D014408:Biomarkers, Tumor / Q000378:metabolism; D018276:Carcinoma, Medullary / Q000151:congenital / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000601:surgery; D018278:Carcinoma, Neuroendocrine; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D018813:Multiple Endocrine Neoplasia Type 2a / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015999:Multivariate Analysis; D009336:Necrosis; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000378:metabolism / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome; D047368:Tumor Burden
D014408:Biomarkers, Tumor