Analysis Of Postoperative Survival And Prognostic Factors For Patients With Medullary Thyroid Carcinoma

Objective: To investigate the postoperative survival and factors affecting the prognosis of medullary thyroid carcinoma(MTC).Methods: The data of 78 MTC patients admitted to Shengjing Hospital affiliated to China Medical University from January 2001 to December 2017 was retrospectively analyzed.These patients were followed by telephone,SMS and patients' review data.The research indexes included: age,gender,primary tumor size,primary tumor involvement range,whether the tumor has extracellular invasion,the way of the first thyroid surgery,the range of cervical lymph node dissection,the metastasis of cervical lymph nodes,the clinical staging of the tumor at the time of diagnosis(cTNM staging),the number of tumors,whether the recurrence,family history,pathological types(simple medullary thyroid carcinoma,medullary carcinoma with papillary carcinoma,medullary carcinoma with nodular goiter),whether distant metastasis.The survival rate of the patients was calculated based on the follow-up results.Single factor and multi-factor regression analysis were used to determine the influencing factors of prognosis.Results: Of the 78 patients,follow-up was obtained in 74 cases for 3 to 189 months.Ten patients died of the disease and all the remaining patients were alive.The 1-,3-,5-,10-,and 15-year survival rates of the patients were98.6%,93.5%,88.4%,73.2%,and 73.2%,respectively.Univariate analysis showed that the sex(?2=6.873,P=0.009)and cervical lymph node metastasis(?2=4.047,P=0.048),distant metastasis(?2=23.530,P<0.001),and clinical stage of the tumor(cTNM stage)(?2=16.067,P<0.001)affected the prognosis of patients;multivariate analysis showed that distant metastasis(HR=54.956,95% CI=6.341 476.257,P<0.001)and cTNM stage(HR=2.214,95%CI=1.061 4.619,P=0.034)were independent factors affecting the survival of MTC patients.Conclusion: Distant metastases and advanced cTNM stage are important factors for unfavorable prognosis of MTC,and early diagnosis and treatment can ensure the long-term survival of the patients.