Affiliation:
1. Department of Visceral, Vascular and Endocrine Surgery, Martin Luther
University of Halle-Wittenberg Faculty of Medicine, Halle, Germany
2. Department of General, Visceral and Transplantation Surgery, Division
of Endocrine Surgery, University of Duisburg-Essen, Faculty of Medicine, Essen,
Germany
Abstract
AbstractLittle is known about axillary node metastasis of medullary thyroid cancer (MTC).
To address this, a comparative study of patients with and without axillary node
metastases of MTC was conducted. Among 1215 consecutive patients with MTC, 482
patients had node-negative MTC and 733 patients node-positive MTC. Among the 733
patients with node-positive MTC, 4 patients (0.5%) had axillary node
metastases, all of which were ipsilateral. Patients with axillary node
metastases had 5.7–6.9-fold more node metastases removed, both at the
authors’ institution (medians of 34.5 vs. 5 metastases; p=0.011)
and in total (medians of 57 vs. 10 metastases; p=0.013), developed more
frequently distant metastases (3 of 4 vs. 178 of 729 patients, or 75 vs.
24%; p=0.049), specifically to bone (2 of 4 vs. 67 of 729
patients, or 50 vs. 9%; p=0.046) and brain (1 of 4 vs. 4 of 729
patients, or 25 vs. 0.5%; p=0.027), and more often succumbed to
cancer-specific death (3 of 4 vs. 52 of 729 patients, or 75 vs. 14%;
p=0.005). Altogether, patients with axillary node metastases revealed
4–8-fold more node metastases in the ipsilateral lateral neck (medians
of 11 vs. 3 metastases; p=0.021) and in the ipsilateral central neck
(medians of 8 vs. 1 metastases; p=0.079) patients without axillary node
metastases. Cancer-specific survival of patients with vs. patients without
axillary node metastases of MTC was significantly shorter (means of 41 vs. 224
months; plog-rank<0.001). These findings show that patients with
axillary node metastases of MTC have massive metastatic dissemination with poor
survival.
Subject
Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,General Medicine,Endocrinology, Diabetes and Metabolism