title: Medullary thyroid carcinoma with nodular goiter carries an excellent prognosis.
abstract: BACKGROUND
  In our institution, patients with medullary thyroid carcinoma (MTC) concurrent with nodular goiter (NG) have a nearly 100% survival rate, but the reasons and characteristics are unclear.
  
  
  METHODS
  Eighty patients with MTC who underwent surgery in our center between 1971 and 2011 were reviewed.
  
  
  RESULTS
  A total of 21 MTC/NG and 59 MTC only patients were identified. The stage of the two groups had no significant difference (P = 0.13). The MTC/NG group had lower preoperative serum calcitonin (CT) levels (914.7 ng/L vs. 1162.6 ng/L, P = 0.003), lower postoperative serum CT levels (371.4 ng/L vs. 582.5 ng/L, P < 0.001), lower carcinoembryonic antigen levels (18.3 ng/ml vs. 130.5 ng/ml, P < 0.001), a lower propensity toward lymph node metastasis (40.0% vs. 66.7%, P = 0.07), and a lower proportion of multifocality (19.1% vs. 42.4%, P = 0.06), capsular invasion (9.5% vs. 25.4%, P = 0.21), and vascular invasion (4.8% vs. 10.1%, P = 0.67). The mean tumor diameter of the two groups was similar (20.3 mm vs. 22.1 mm, P = 0.6). Overall 15-year survival in MTC/NG versus MTC only groups was 100% versus 57.0% (P = 0.03).
  
  
  CONCLUSIONS
  MTC with NG is an indolent disease and has an excellent prognosis. The only independent predictor of survival was the TNM stage of disease.
authors.affiliation: Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
authors.forename: Lai
authors.initials: L
authors.lastname: Xu
authors.forename: Wei-Bin
authors.initials: WB
authors.lastname: Wang
authors.forename: Yu-Pei
authors.initials: YP
authors.lastname: Zhao
authors.forename: Tai-Ping
authors.initials: TP
authors.lastname: Zhang
authors.forename: Quan
authors.initials: Q
authors.lastname: Liao
authors.forename: Ge
authors.initials: G
authors.lastname: Chen
authors.forename: Li
authors.initials: L
authors.lastname: Zhou
authors.forename: Hong
authors.initials: H
authors.lastname: Shu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000097:blood; D002116:Calcitonin / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D018276:Carcinoma, Medullary / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002681:China / Q000453:epidemiology; D005260:Female; D006044:Goiter, Nodular / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009423:Nervous System Neoplasms / Q000556:secondary; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018401:Sample Size; D013964:Thyroid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D019043:Vascular Neoplasms / Q000556:secondary
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D002116:Calcitonin