Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and Survival

Background The benefits of early detection in medullary thyroid carcinoma (MTC) are not well established. This study investigates the impact of early detection of MTC on clinical outcomes. Methods This retrospective study evaluated 144 patients diagnosed with MTC at Samsung Medical Center between 19...

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Main Authors: Ji Hyun Yoo, Da Eun Leem, Bo Ram Kim, Tae Hyuk Kim, Sun Wook Kim, Jae Hoon Chung
Format: Article
Language:English
Published: Korean Endocrine Society 2025-06-01
Series:Endocrinology and Metabolism
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Online Access:http://www.e-enm.org/upload/pdf/enm-2024-2214.pdf
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author Ji Hyun Yoo
Da Eun Leem
Bo Ram Kim
Tae Hyuk Kim
Sun Wook Kim
Jae Hoon Chung
author_facet Ji Hyun Yoo
Da Eun Leem
Bo Ram Kim
Tae Hyuk Kim
Sun Wook Kim
Jae Hoon Chung
author_sort Ji Hyun Yoo
collection DOAJ
description Background The benefits of early detection in medullary thyroid carcinoma (MTC) are not well established. This study investigates the impact of early detection of MTC on clinical outcomes. Methods This retrospective study evaluated 144 patients diagnosed with MTC at Samsung Medical Center between 1995 and 2019, classified as asymptomatic (mostly detected through routine health check-ups, including ultrasonography, calcitonin, or carcinoembryonic antigen levels) and symptomatic. Initial treatment response, final clinical outcomes, and cancer-specific survival were compared. Results MTC was diagnosed in 104 (72.2%) asymptomatic and 40 (27.8%) symptomatic patients. The symptomatic group showed a significantly larger primary tumor size, more frequent lateral neck lymph node metastasis, more advanced tumor, node, metastasis (TNM) staging, and higher pre- and postoperative serum calcitonin levels. For initial treatment response, the proportion of excellent responders was significantly higher in the asymptomatic group (71.2% vs. 40.0%), while that of patients with biochemical incomplete response (37.5% vs. 26.9%) and structural incomplete response (22.5% vs. 1.9%) was significantly higher in the symptomatic group (all P<0.001). For the final clinical outcomes, the rate of patients with no evidence of disease was higher in the asymptomatic group (67.3% vs. 30.0%), while the rate of patients with structurally identifiable disease was higher in the symptomatic group (45.0% vs. 7.7%) (P<0.001 for both). The symptomatic group had significantly poorer cancer-specific survival than the asymptomatic group (log-rank P=0.023). Conclusion Compared with late diagnosis through symptomatic presentation, early diagnosis in asymptomatic patients results in significantly better initial treatment response, final clinical outcomes, and cancer-specific survival in patients with MTC.
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spelling doaj-art-d72bfb4f8bc64739a7ee211bb7e501832025-08-20T03:29:10ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782025-06-0140341442010.3803/EnM.2024.22142592Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and SurvivalJi Hyun Yoo0Da Eun Leem1Bo Ram Kim2Tae Hyuk Kim3Sun Wook Kim4Jae Hoon Chung5 Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea Division of Endocrinology and Metabolism, Department of Medicine, Thyroid Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, KoreaBackground The benefits of early detection in medullary thyroid carcinoma (MTC) are not well established. This study investigates the impact of early detection of MTC on clinical outcomes. Methods This retrospective study evaluated 144 patients diagnosed with MTC at Samsung Medical Center between 1995 and 2019, classified as asymptomatic (mostly detected through routine health check-ups, including ultrasonography, calcitonin, or carcinoembryonic antigen levels) and symptomatic. Initial treatment response, final clinical outcomes, and cancer-specific survival were compared. Results MTC was diagnosed in 104 (72.2%) asymptomatic and 40 (27.8%) symptomatic patients. The symptomatic group showed a significantly larger primary tumor size, more frequent lateral neck lymph node metastasis, more advanced tumor, node, metastasis (TNM) staging, and higher pre- and postoperative serum calcitonin levels. For initial treatment response, the proportion of excellent responders was significantly higher in the asymptomatic group (71.2% vs. 40.0%), while that of patients with biochemical incomplete response (37.5% vs. 26.9%) and structural incomplete response (22.5% vs. 1.9%) was significantly higher in the symptomatic group (all P<0.001). For the final clinical outcomes, the rate of patients with no evidence of disease was higher in the asymptomatic group (67.3% vs. 30.0%), while the rate of patients with structurally identifiable disease was higher in the symptomatic group (45.0% vs. 7.7%) (P<0.001 for both). The symptomatic group had significantly poorer cancer-specific survival than the asymptomatic group (log-rank P=0.023). Conclusion Compared with late diagnosis through symptomatic presentation, early diagnosis in asymptomatic patients results in significantly better initial treatment response, final clinical outcomes, and cancer-specific survival in patients with MTC.http://www.e-enm.org/upload/pdf/enm-2024-2214.pdfthyroid neoplasmsthyroid cancer, medullaryearly detection of cancer
spellingShingle Ji Hyun Yoo
Da Eun Leem
Bo Ram Kim
Tae Hyuk Kim
Sun Wook Kim
Jae Hoon Chung
Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and Survival
Endocrinology and Metabolism
thyroid neoplasms
thyroid cancer, medullary
early detection of cancer
title Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and Survival
title_full Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and Survival
title_fullStr Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and Survival
title_full_unstemmed Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and Survival
title_short Medullary Thyroid Carcinoma Detected by Routine Health Screening Had Better Clinical Outcome and Survival
title_sort medullary thyroid carcinoma detected by routine health screening had better clinical outcome and survival
topic thyroid neoplasms
thyroid cancer, medullary
early detection of cancer
url http://www.e-enm.org/upload/pdf/enm-2024-2214.pdf
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