Valor pronóstico de las características clínicas, histopatológicas e inmunohistoquímicas en el carcinoma medular de tiroides

Abstract

Background and objectiveTo analyze the importance of various clinical, histopathological and immunohistochemical features in the prognosis of resected medullary thyroid carcinoma. Patients and methodsA total of 55 cases of medullary thyroid carcinoma consecutively operated were investigated. The data referring to clinical features were collected in the patient's clinical history. The histopathological and immunohistochemical features of the tumors were taken from their pathological anatomy report. ResultsSurvival at one year was 96±2%; at 5 years 91±4%; at 10 years 88±6%; at 15 years 83±7%; and at 20 years 61±14%. Among epidemiological features, tumor type was significantly related with the disease (best familial prognosis; P=.035); among histopathological features, the presence of C cell hyperplasia and the presence of tumor necrosis had a significant relationship (P=.0005 and P=.039); among immunohistochemical features, positivity for p53 and for c-erb-b2 (P=.023 and P=.022); and finally, among staging data, TNM clinical staging (P=.015), size (P=.046) and the presence of distant metastases (P=.002). According to Cox's regression model, the only variables indicating a poor prognosis were: the existence of necrosis (P=.039; OR=6.513) and tumor size>4cm (P=.027; OR=14.196). ConclusionsThe survival rate was mainly determined by tumor size and the presence of tumor necrosis. None of the immunohistochemical markers had a significant influence on survival.