The impact of preoperative calcitonin screening on the prognosis of patients with medullary thyroid cancer: a...

Area of Science:

• Endocrinology
• Surgical Oncology
• Oncologic Diagnostics

Background:

• Controversy exists regarding the necessity of routine preoperative calcitonin (Ctn) testing for medullary thyroid cancer (MTC).
• Preoperative Ctn levels may influence surgical strategy and extent in MTC management.

Purpose of the Study:

• To evaluate the impact of preoperative calcitonin (Ctn) screening on surgical extent and patient outcomes in medullary thyroid cancer (MTC).

Main Methods:

• Retrospective multicenter cohort study of 149 MTC patients (2013-2023).
• Comparison of clinical characteristics, surgical procedures, and outcomes between Ctn-screened and non-screened groups.
• Kaplan-Meier analysis for recurrence-free survival (RFS) and overall survival (OS).

Main Results:

• 127 patients underwent Ctn screening; 22 did not.
• Ctn-screened patients received more radical surgery (total thyroidectomy and lymph node dissection).
• Lower rates of recurrence (16.1% vs. 36.4%) and death (0.8% vs. 18.2%) were observed in the Ctn-screened group.
• Significantly better overall survival in the Ctn-screened group (p=0.001); no significant difference in RFS.

Conclusions:

• Preoperative Ctn screening encourages more radical initial surgical treatment for MTC.
• This approach may lead to improved long-term patient outcomes.
• Further cost-effectiveness analysis of routine Ctn screening in thyroid nodule patients is recommended.