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The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma

The value of postoperative radiotherapy in the treatment of medullary thyroid carcinoma (MTC) has not been unequivocally demonstrated. Therefore our study aimed to answer the question of whether adjuvant radiotherapy showed any impact on the risk of local recurrence and whether there were any differ...

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Autores principales: Kukulska, Aleksandra, Krajewska, Jolanta, Kolosza, Zofia, Paliczka-Cieslik, Ewa, Kropinska, Aleksandra, Pawlaczek, Agnieszka, Puch, Zbigniew, Ficek, Kornelia, Lisik, Teresa, Sygula, Dorota, Wygoda, Zbigniew, Roskosz, Jozef, Wydmanski, Jerzy, Jarzab, Barbara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bioscientifica Ltd 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933828/
https://www.ncbi.nlm.nih.gov/pubmed/31778360
http://dx.doi.org/10.1530/EC-19-0387
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author Kukulska, Aleksandra
Krajewska, Jolanta
Kolosza, Zofia
Paliczka-Cieslik, Ewa
Kropinska, Aleksandra
Pawlaczek, Agnieszka
Puch, Zbigniew
Ficek, Kornelia
Lisik, Teresa
Sygula, Dorota
Wygoda, Zbigniew
Roskosz, Jozef
Wydmanski, Jerzy
Jarzab, Barbara
author_facet Kukulska, Aleksandra
Krajewska, Jolanta
Kolosza, Zofia
Paliczka-Cieslik, Ewa
Kropinska, Aleksandra
Pawlaczek, Agnieszka
Puch, Zbigniew
Ficek, Kornelia
Lisik, Teresa
Sygula, Dorota
Wygoda, Zbigniew
Roskosz, Jozef
Wydmanski, Jerzy
Jarzab, Barbara
author_sort Kukulska, Aleksandra
collection PubMed
description The value of postoperative radiotherapy in the treatment of medullary thyroid carcinoma (MTC) has not been unequivocally demonstrated. Therefore our study aimed to answer the question of whether adjuvant radiotherapy showed any impact on the risk of local recurrence and whether there were any differences in response to radiotherapy between hereditary and sporadic MTC. METHODS: A retrospective analysis involved 254 MTC patients, among them 73 patients with a hereditary disease. Two hundred and twenty-four patients, including 43 persons at a high risk of local relapse, underwent only initial surgery; 18 other patients were operated due to MTC recurrences, whereas the remaining 12 patients had cytoreductive procedure or were not amenable for surgery. Radiotherapy was carried out in 132 patients. One hundred and twenty patients underwent adjuvant radiotherapy, among them 102 patients after initial surgery. The median follow-up was 10 years (range 0.5–29 years). RESULTS: Local recurrence occurred in 107/254 patients, among them in 63 subjects after prior radiotherapy. The frequency of relapse showed significantly increasing trend toward higher MTC stages (P <0.001). More relapses occurred in patients with lymph node metastases present at MTC onset. Adjuvant radiotherapy was associated with a lower risk of nodal recurrence only in high-risk patients, particularly if lymph node metastases were present at MTC diagnosis. The differences between hereditary and sporadic subgroups were not significant. CONCLUSIONS: Adjuvant radiotherapy has a limited importance in MTC treatment. It should be considered in high-risk MTC patients. The presence of RET mutation does not influence the response to radiation.
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spelling pubmed-69338282019-12-30 The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma Kukulska, Aleksandra Krajewska, Jolanta Kolosza, Zofia Paliczka-Cieslik, Ewa Kropinska, Aleksandra Pawlaczek, Agnieszka Puch, Zbigniew Ficek, Kornelia Lisik, Teresa Sygula, Dorota Wygoda, Zbigniew Roskosz, Jozef Wydmanski, Jerzy Jarzab, Barbara Endocr Connect Research The value of postoperative radiotherapy in the treatment of medullary thyroid carcinoma (MTC) has not been unequivocally demonstrated. Therefore our study aimed to answer the question of whether adjuvant radiotherapy showed any impact on the risk of local recurrence and whether there were any differences in response to radiotherapy between hereditary and sporadic MTC. METHODS: A retrospective analysis involved 254 MTC patients, among them 73 patients with a hereditary disease. Two hundred and twenty-four patients, including 43 persons at a high risk of local relapse, underwent only initial surgery; 18 other patients were operated due to MTC recurrences, whereas the remaining 12 patients had cytoreductive procedure or were not amenable for surgery. Radiotherapy was carried out in 132 patients. One hundred and twenty patients underwent adjuvant radiotherapy, among them 102 patients after initial surgery. The median follow-up was 10 years (range 0.5–29 years). RESULTS: Local recurrence occurred in 107/254 patients, among them in 63 subjects after prior radiotherapy. The frequency of relapse showed significantly increasing trend toward higher MTC stages (P <0.001). More relapses occurred in patients with lymph node metastases present at MTC onset. Adjuvant radiotherapy was associated with a lower risk of nodal recurrence only in high-risk patients, particularly if lymph node metastases were present at MTC diagnosis. The differences between hereditary and sporadic subgroups were not significant. CONCLUSIONS: Adjuvant radiotherapy has a limited importance in MTC treatment. It should be considered in high-risk MTC patients. The presence of RET mutation does not influence the response to radiation. Bioscientifica Ltd 2019-11-28 /pmc/articles/PMC6933828/ /pubmed/31778360 http://dx.doi.org/10.1530/EC-19-0387 Text en © 2020 The authors http://creativecommons.org/licenses/by-nc/4.0/ This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Research
Kukulska, Aleksandra
Krajewska, Jolanta
Kolosza, Zofia
Paliczka-Cieslik, Ewa
Kropinska, Aleksandra
Pawlaczek, Agnieszka
Puch, Zbigniew
Ficek, Kornelia
Lisik, Teresa
Sygula, Dorota
Wygoda, Zbigniew
Roskosz, Jozef
Wydmanski, Jerzy
Jarzab, Barbara
The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma
title The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma
title_full The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma
title_fullStr The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma
title_full_unstemmed The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma
title_short The role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma
title_sort role of postoperative adjuvant radiotherapy in local recurrence risk in medullary thyroid carcinoma
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6933828/
https://www.ncbi.nlm.nih.gov/pubmed/31778360
http://dx.doi.org/10.1530/EC-19-0387
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