Abstract
Serum levels of calcitonin and CEA represent useful tumor markers for medullary thyroid carcinoma (MTC). CEA secretion-rich MTCs are considered more aggressive than calcitonin-rich tumors. We examined the significance of the ratio of serum calcitonin (pg/ml) to CEA (ng/ml) as a prognostic factor for MTC. Between 1986 and 2002, a total of 20 patients with MTC underwent surgery at our institute. Tumor type was sporadic in 13 cases, and hereditary in 7 patients from 3 families. Tumors were recurrent in 5 patients, and the 5-year disease-free survival was 80%. Recurrences occurred in the mediastinum in 4 patients, cervical lymph nodes in 3, and liver in 2. The 2 patients with hepatic recurrence died of the disease, and the 5-year disease-specific survival was 88%. Preoperative calcitonin/CEA ratio ≤10 and ≥10 pathological metastatic nodes represented significant prognostic factors for disease-free survival. No recurrence was found in 13 patients with biochemical cure (normalization of both serum calcitonin and CEA) after surgery. These 13 patients were the same patients with preoperative calcitonin/CEA>10. The preoperative serum calcitonin/CEA ratio can be used as a prognostic factor for patients with MTC.
