Highlights
- •MMFTC exhibits worse overall survival when compared to MMPTC, MTC, FTC and PTC.
- •Mixed medullary thyroid tumors present with more advanced disease.
- •In both MMFTC and MMPTC patients of the lowest income cohort exhibited the greatest risk of mortality.
Abstract
Background
Mixed medullary-papillary thyroid carcinoma (MMPTC) and mixed medullary-follicular
thyroid carcinoma (MMFTC) are rare variants with little known regarding behavior and
prognosis.
Methods
Using the National Cancer Database (NCDB), demographics, clinicopathologic features,
treatment, and overall survival (OS) from patients with MMPTC and MMFTC were compared
to more prevalent subtypes.
Results
There were 296,101 patients: 421 MMPTC (0.14%), 133 MMFTC (0.04%), 263,140 PTC (88.87%),
24,208 FTC (8.18%) and 8,199 MTC (2.77%). Compared to PTC, MMPTC and MMFTC patients
were older (p < 0.001) with a higher Charlson-Deyo comorbidity index (p < 0.001).
Mixed tumors exhibited lower rates of nodal disease but more distant metastases compared
to PTC (p < 0.001). MMPTC demonstrated lower estimated 10-year OS than PTC and FTC
(76.04%vs 89.04% and 81.95%,p < 0.001), yet higher than MTC (70.29%,p < 0.001). MMFTC
had a worse OS compared to all groups (63.32%,p < 0.001).
Conclusion
Patients with MMFTC had significantly worse OS compared to DTC, portending a worse
prognosis.
Keywords
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References
- Mixed medullary-papillary thyroid carcinoma with mixed lymph node metastases: a case report.Clin Case Rep. 2021; 9 (May)e04165https://doi.org/10.1002/ccr3.4165
- Medullary and papillary carcinoma of the thyroid gland occurring as a collision tumor with lymph node metastasis: a case report.J Med Case Rep. Dec 20 2011; 5: 590https://doi.org/10.1186/1752-1947-5-590
- Mixed medullary-papillary carcinoma of the thyroid: report of a case and review of the literature.Head Neck. 2009; 31 (Jul): 968-974https://doi.org/10.1002/hed.20984
- Mixed medullary-follicular thyroid carcinoma. Molecular evidence for a dual origin of tumor components.Am J Pathol. 1999; 155 (Nov): 1499-1509https://doi.org/10.1016/S0002-9440(10)65465-X
- Simultaneous medullary and differentiated thyroid cancer: a population-level analysis of an increasingly common entity.Ann Surg Oncol. 2012; 19 (Aug): 2635-2642https://doi.org/10.1245/s10434-012-2357-8
- Intermixed medullary and papillary thyroid cancer in a patient with renal cell carcinoma.Endocrinol Diabetes Metab Case Rep. Jun 4 2020; (2020)https://doi.org/10.1530/EDM-20-0025
- Mixed subtype thyroid cancer: a surveillance, epidemiology, and end results database analysis.Oncotarget. Oct 17 2017; 8: 86556-86565https://doi.org/10.18632/oncotarget.21242
- A new method of classifying prognostic comorbidity in longitudinal studies: development and validation.J Chron Dis. 1987; 40: 373-383https://doi.org/10.1016/0021-9681(87)90171-8
- Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma.Thyroid. 2015; 25 (Jun): 567-610https://doi.org/10.1089/thy.2014.0335
Article info
Publication history
Published online: February 09, 2023
Accepted:
February 8,
2023
Received in revised form:
January 28,
2023
Received:
December 7,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
