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Kinetic analysis of the growth rate of sporadic and hereditary medullary thyroid carcinoma: Comparing the postoperative calcitonin-doubling rate with the hypothetical preoperative tumor volume-doubling rate
Minoru Kihara
Kuma Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1778-5177
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Thyroid Research.
Background
Our previous kinetic analyses of changes in the tumor volume (TV) of papillary thyroid microcarcinomas during active surveillance revealed that the tumors' growth varied over time from rather rapid growth to shrinkage and that the hypothetical TV-doubling rates (DRs) before the patients' presentation were much larger than their observed TV-DRs, indicating that rapid growth phases preceded their presentation. Whether this phenomenon also occurs in medullary thyroid carcinoma (MTC) was unknown.
Methods
We retrospectively analyzed the cases of 46 MTC patients (18 hereditary, 28 sporadic; 9–80 years old at surgery, median 53.5 years; 19 males and 27 females) with elevated postoperative calcitonin (Ct) suggesting persistent disease. We calculated each patient's Ct-DR and his/her hypothetical TV-DR, using the tumor size and age at surgery.
Results
Ct-DRs (/year) after surgery were >0.5, 0.1–0.5, −0.1–0.1, and <−0.1 in 9, 21, 12, and 4 patients, respectively (median 0.17). The hypothetical TV-DRs (/year) before surgery were >1, 0.5–1.0, 0.1–0.5 and <0.1 in 11, 21, 14, and 0 patients, respectively (median 0.60). The hypothetical TV-DR was higher than the observed Ct-DR in 41 of the 46 MTC patients and all 18 patients with hereditary MTC, suggesting that a rapid growth phase preceded surgery in these patients.
Conclusions
In this series of MTC patients, the pre-surgery calculated hypothetical TV-DRs were significantly higher than the Ct-DRs observed post-surgery, suggesting that there were rapid growth periods before surgery in the vast majority of these MTC patients, especially those with hereditary MTC.
Keywords
kinetic analysis of the growth rate, doubling rate, medullary thyroid carcinoma, calcitonin, tumor volume
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CURRENT STATUS: Published
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Posted 24 Jun, 2020
Published
On 21 Jul, 2020
No community comments so far
Editorial decision: Accept
On 07 Jul, 2020
Review #1 received
Received 01 Jul, 2020
Reviewer #1 agreed
On 26 Jun, 2020
Reviewers invited
Invitations sent on 24 Jun, 2020
Editor assigned
On 24 Jun, 2020
Submission checks complete
On 23 Jun, 2020
Editor invited
On 23 Jun, 2020
No comments provided
Editorial decision: Major Revision
On 20 Jun, 2020
Review #1 received
Received 03 Jun, 2020
Review #2 received
Received 31 May, 2020
Review #3 received
Received 31 May, 2020
Reviewer #3 agreed
On 27 May, 2020
Reviewer #2 agreed
On 25 May, 2020
Reviewer #1 agreed
On 12 May, 2020
Reviewers invited
Invitations sent on 11 May, 2020
First submitted
On 10 May, 2020
Editor assigned
On 10 May, 2020
Submission checks complete
On 09 May, 2020
Editor invited
On 09 May, 2020
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Subject Areas
Endocrinology & Metabolism
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This preprint is under consideration at Thyroid Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Kinetic analysis of the growth rate of sporadic and hereditary medullary thyroid carcinoma: Comparing the postoperative calcitonin-doubling rate with the hypothetical preoperative tumor volume-doubling rate
Minoru Kihara
Kuma Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1778-5177
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 24 Jun, 2020
Published
On 21 Jul, 2020
No community comments so far
Editorial decision: Accept
On 07 Jul, 2020
Review #1 received
Received 01 Jul, 2020
Reviewer #1 agreed
On 26 Jun, 2020
Reviewers invited
Invitations sent on 24 Jun, 2020
Editor assigned
On 24 Jun, 2020
Submission checks complete
On 23 Jun, 2020
Editor invited
On 23 Jun, 2020
No comments provided
Editorial decision: Major Revision
On 20 Jun, 2020
Review #1 received
Received 03 Jun, 2020
Review #2 received
Received 31 May, 2020
Review #3 received
Received 31 May, 2020
Reviewer #3 agreed
On 27 May, 2020
Reviewer #2 agreed
On 25 May, 2020
Reviewer #1 agreed
On 12 May, 2020
Reviewers invited
Invitations sent on 11 May, 2020
First submitted
On 10 May, 2020
Editor assigned
On 10 May, 2020
Submission checks complete
On 09 May, 2020
Editor invited
On 09 May, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Endocrinology & Metabolism
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Thyroid Research.
Background
Our previous kinetic analyses of changes in the tumor volume (TV) of papillary thyroid microcarcinomas during active surveillance revealed that the tumors' growth varied over time from rather rapid growth to shrinkage and that the hypothetical TV-doubling rates (DRs) before the patients' presentation were much larger than their observed TV-DRs, indicating that rapid growth phases preceded their presentation. Whether this phenomenon also occurs in medullary thyroid carcinoma (MTC) was unknown.
Methods
We retrospectively analyzed the cases of 46 MTC patients (18 hereditary, 28 sporadic; 9–80 years old at surgery, median 53.5 years; 19 males and 27 females) with elevated postoperative calcitonin (Ct) suggesting persistent disease. We calculated each patient's Ct-DR and his/her hypothetical TV-DR, using the tumor size and age at surgery.
Results
Ct-DRs (/year) after surgery were >0.5, 0.1–0.5, −0.1–0.1, and <−0.1 in 9, 21, 12, and 4 patients, respectively (median 0.17). The hypothetical TV-DRs (/year) before surgery were >1, 0.5–1.0, 0.1–0.5 and <0.1 in 11, 21, 14, and 0 patients, respectively (median 0.60). The hypothetical TV-DR was higher than the observed Ct-DR in 41 of the 46 MTC patients and all 18 patients with hereditary MTC, suggesting that a rapid growth phase preceded surgery in these patients.
Conclusions
In this series of MTC patients, the pre-surgery calculated hypothetical TV-DRs were significantly higher than the Ct-DRs observed post-surgery, suggesting that there were rapid growth periods before surgery in the vast majority of these MTC patients, especially those with hereditary MTC.
Figure 1
Figure 2
Figure 3