THYROID MEDULLAR CARCINOMA - PROGNOSTIC F ACTORS

Objective. To analize the clinical features and possible prognostic fa ctors involved in the clinical course of a series of 26 patients with the diagnosis of thyroid medullar carcinoma (TMC). Materials and metho ds. An analysis was made of the variables age, sex, clinical course to diagnosis, paraneoplastic manifestations (flush, diarrhoea), clinical type (sporadic, non-associated, familial MEN IIa associated TMC, fami lial MEN IIb associated TMC), histologic uni or multicentricity, and s tage of disease as possible predictive factors for the evolution. Resu lts. The most remarkable prognostic factor was tumoral stage. The like lihood of a patient diagnosed with stage I or II being free of metasta tic disease was 1, 0.66 and 0.33 at 15, 16 and 17 years, respectively. In contrast, those patients in stage III at diagnosis had a likelihoo d of being free from metastasis 5 years after diagnosis and therapy of 0. With regard to sex, a better clinical course was observed among ma les than among females, statistically significant at 3 and 5, but not at 10 years. No statistical significance was reached with the other po ssible prognostic factors investigated. Conclusion. Given the obvious influence of tumoral stage of disease on prognosis, an early access to medical attention is desirable for diagnosis and treatment of TMC, as well as an early detection of family cases by a screening test.