Correlation between preoperative ultrasonic features of medullary thyroid carcinoma and postoperative recurrence

To investigate the factors that affect postoperative recurrence in medullary thyroid carcinoma (MTC) patients, including preoperative ultrasonic characteristics and other factors.

A retrospective analysis of 7 MTC patients who underwent the first thyroid surgery from 2009 to 2018 and who had complete follow-up data was conducted. According to the follow-up results, these patients were divided into the recurrence group (17 cases) and non-recurrence group (57 cases). The preoperative ultrasound characteristics, preoperative and postoperative calcitonin levels, and general informations of the two groups were recorded, respectively. Univariate and multivariate analyses were performed.

Single factor Kaplan-Meier (K-M) analysis showed that: ① Preoperative ultrasonic characteristics including tumor size > 40.0 mm, capsular invasion, and metastatic cervical lymph nodes, as well as preoperative calcitonin level > 565.8 pg/ml, and postoperative calcitonin (within one week) level > 45.0 pg/ml were positively correlated with the risk of postoperative recurrence of MTC (P < 0.05); ② There was no evidence to show that sex and age had a statistically significant effect on postoperative recurrence of MTC (P > 0.05). Multivariate Cox regression analysis showed that metastatic lymph nodes shown by ultrasound (HR = 5.368, 95%CI 1.063-27.104, P = 0.042) was an independent risk factor for postoperative recurrence of MTC.

MTC patients with metastatic lymph nodes shown by ultrasound are prone to postoperative recurrence of MTC. In addition, MTC patients with a tumor > 40.0 mm, capsular invasion, preoperative calcitonin level > 565.8 pg/ml, and postoperative calcitonin level > 45.0 pg/ml are more likely to have postoperative recurrence.