Evaluation of Survival and Postoperative Radiation Among Patients with Advanced Medullary Thyroid Carcinoma: An Analysis of the National Cancer Database

Background This study compared survival between patients who had medullary thyroid cancer (MTC) treated with surgery alone and patients who underwent surgery and radiation (SRT). Methods Patients from the National Cancer Database (NCDB) with a diagnosis of stage 3 or 4 MTC, lymph node disease, and n...

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Bibliographic Details
Published in:Annals of surgical oncology 2022-04, Vol.29 (4), p.2582-2591
Main Authors: Ow, Thomas J., Mehta, Vikas, Kim, Seokhwa, Vakil, Mayand, Friedmann, Patricia, In, Haejin
Format: Article
Language:English
Subjects:
Bias
Carcinoma, Neuroendocrine - pathology
Carcinoma, Neuroendocrine - radiotherapy
Carcinoma, Neuroendocrine - surgery
Endocrine Tumors
Humans
Kaplan-Meier Estimate
Lymph nodes
Lymphatic system
Medicine
Medicine & Public Health
Metastases
Mortality
Neoplasm Staging
Oncology
Patients
Postoperative period
Proportional Hazards Models
Radiation
Retrospective Studies
Statistical analysis
Surgery
Surgical Oncology
Survival
Thyroid cancer
Thyroid carcinoma
Thyroid Neoplasms - radiotherapy
Thyroid Neoplasms - surgery
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Summary:Background This study compared survival between patients who had medullary thyroid cancer (MTC) treated with surgery alone and patients who underwent surgery and radiation (SRT). Methods Patients from the National Cancer Database (NCDB) with a diagnosis of stage 3 or 4 MTC, lymph node disease, and no distant metastases between 2008 and 2016 were studied. Kaplan–Meier analyses and log-rank statistics were used to estimate and compare overall survival between patients treated with surgery alone and those treated with SRT. Mutlivariable Cox proportional hazards models and propensity-matching were used to adjust for confounding and selection bias. Results Among 1370 patients, 1112 (81%) received surgery alone, and 258 (19%) received SRT. The hazard ratio for mortality in the SRT group was 1.784 (95% confidence interval [CI] 1.313–2.43) after multivariable adjustment for confounding variables. Furthermore, SRT remained associated with a higher mortality rate ( p  
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-021-11158-9