Dataset Information

Preoperative Serum Calcitonin and Its Correlation with Extent of Lymph Node Metastasis in Medullary Thyroid Carcinoma.

ABSTRACT: The optimal initial surgical extent for medullary thyroid carcinoma (MTC) remains controversial. Previous studies on serum calcitonin are limited to reporting the calcitonin threshold according to anatomical disease burden. Here, we evaluated whether preoperative calcitonin levels can be used to predict optimal surgical extent. We retrospectively reviewed the 170 patients with MTC at a tertiary Korean hospital from 1994 to 2019. We extracted data on preoperative calcitonin level, primary tumor size and the number and location of lymph node metastases (LNMs). To evaluate disease extent, we divided the patients into five groups: no LNM, central LNM, ipsilateral lateral LNM, contralateral lateral LNM, and distant metastasis. We calculated the positive and negative likelihood ratios (LRs) for multiple categories of preoperative calcitonin levels. Preoperative calcitonin level positively correlated with primary tumor size (rho = 0.744, p < 0.001) and LNM number (rho = 0.537, p < 0.001). Preoperative calcitonin thresholds of 20, 200, and 500 pg/mL were associated with the presence of ipsilateral lateral LNM, contralateral lateral LNM, and distant metastasis, respectively. The negative LRs were 0.1 at a preoperative calcitonin cut-off of 100 pg/mL in the central LNM, 0.18 at a cut-off of 300 pg/mL in the ipsilateral lateral LNM, and 0 at a cut-off of 300 pg/mL in the contralateral lateral LNM. The preoperative calcitonin level correlates with disease extent and has diagnostic value for predicting LNM extent. Our results suggest that the preoperative calcitonin level can be used to determine optimal initial surgical extent.

SUBMITTER: Park H

PROVIDER: S-EPMC7601718 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Preoperative Serum Calcitonin and Its Correlation with Extent of Lymph Node Metastasis in Medullary Thyroid Carcinoma.

Park Hyunju H Park Jun J Choi Min Sun MS Kim Jinyoung J Kim Hosu H Shin Jung Hee JH Kim Jung-Han JH Kim Jee Soo JS Kim Sun Wook SW Chung Jae Hoon JH Kim Tae Hyuk TH

Cancers 20201009 10

The optimal initial surgical extent for medullary thyroid carcinoma (MTC) remains controversial. Previous studies on serum calcitonin are limited to reporting the calcitonin threshold according to anatomical disease burden. Here, we evaluated whether preoperative calcitonin levels can be used to predict optimal surgical extent. We retrospectively reviewed the 170 patients with MTC at a tertiary Korean hospital from 1994 to 2019. We extracted data on preoperative calcitonin level, primary tumor s ...[more]

PMID: 33050233

Similar Datasets

Project description:BACKGROUND:Papillary thyroid carcinoma is a type of indolent tumor with a dramatically increasing incidence rate and stably high survival rate. Reducing the overdiagnosis and overtreatment of papillary thyroid carcinoma is clinically emergent and important. A radiomics model is proposed in this article to predict lymph node metastasis, the most important risk factor of papillary thyroid carcinoma, based on noninvasive routine preoperative ultrasound images. METHODS:Four hundred fifty ultrasound manually segmented images of patients with papillary thyroid carcinoma with lymph node status obtained from pathology report were enrolled in our retrospective study. A radiomics evaluation of 614 high-throughput features were calculated, including size, shape, margin, boundary, orientation, position, echo pattern, posterior acoustic pattern, and calcification features. Then, combined feature selection strategy was used to select features with the greatest ability to discriminate lymph node status. A support vector machine classifier was employed to build and validate the prediction model. Another independent testing cohort was used to further evaluate the performance of the radiomics model. RESULTS:Among 614 radiomics features, 50 selected features most reflecting echo pattern, posterior acoustic pattern, and calcification showed the superior lymph node status distinguishable performance with area under the receiver operating characteristic curve of 0.753, 0.740, and 0.743 separately when using each type of features predicting the lymph node status. The results of model based on all 50 final features predicting the lymph node status shown an area under the receiver operating characteristic curve of 0.782, and accuracy of 0.712. In the independent testing cohort, the proposed approach showed similar results, with area under the receiver operating characteristic curve of 0.727 and accuracy of 0.710. CONCLUSION:Papillary thyroid carcinoma with lymph node metastasis usually shows a complex echo pattern, posterior region homogeneity, and macrocalcification or multiple calcification. The radiomics model proposed in this article is a promising method for assessing the risk of papillary thyroid carcinoma metastasis noninvasively.

Project description:IntroductionGuidelines for prophylactic dissection in clinical central negative node (cN0) of papillary thyroid carcinoma vary among different countries due to the uncertainty on the benefit of dissection. The Chinese guidelines recommend prophylactic central compartment lymph node dissection (pCLND) under professional technology. Preoperative ultrasound (US) evaluation of central lymph node determines the surgical strategy used. Sensitivity differs significantly when US is conducted by different physicians even in diverse hospitals. In this study, the aim was to explore why the Chinese guidelines were different from the America Thyroid Association (ATA) guidelines through the real-world evidence on the preoperative diagnosis of cN0.MethodsPreoperative US and surgical pathology data for 1,015 patients with PTC attending 13 Grade-A tertiary hospitals in 2017 were collected. A retrospective analysis using US assessment of CLNM was the conducted to explore the benefits of this approach in China. US physicians in our hospital were trained on scanning the thyroid gland and its regional lymph nodes in normalization. Data of 1,776 patients were collected under the same condition from 2012 to 2017, whose ultrasonography was performed by diverse physicians and doctors. Further, data of 339 patients evaluated by the same sonographer and operated by the same surgical team was collected between 2015 and 2017. In this set of data, US combined CT versus US alone was compared. Patients were grouped into metastasis group and non-metastasis group based on postoperative pathological diagnosis of CLNM. Diagnostic efficacy of US was evaluated.ResultsA total of 925 patients who underwent preoperative ultrasonography in central lymph node, including 825 cases who underwent thyroidectomy and central lymph node dissection were included in this study. The sensitivity of ultrasonography in detecting CLNM was 23.18%, with occult metastasis rate of 40.8%. Data for 1,776 patients comprising paired ultrasonic report and pathological report were collected in our hospital, whose physicians underwent standardized training. The sensitivity was 37.58%. Furthermore, specialized evaluation showed high sensitivity in US/CT (84.58%) than US (58.21%) alone.ConclusionAlthough the sensitivity of US could be enhanced by standardized training and combination with CT, the prevalence of low sensitivity of US in real-world multicenter data and the high occult metastasis rate indicated that the Chinese guidelines were based on the current conditions.

Dataset Information

Preoperative Serum Calcitonin and Its Correlation with Extent of Lymph Node Metastasis in Medullary Thyroid Carcinoma.

Publications

Preoperative Serum Calcitonin and Its Correlation with Extent of Lymph Node Metastasis in Medullary Thyroid Carcinoma.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets