MYELOstudy: lymph node stage of aggressiveness in medullary thyroid cancer—a retrospective multi-center study analysis

Papavramidis T, Chorti A, Bakkar S, Raffaelli M, Košec A, Hoang VT, Lim JY, Genc V, Minuto MN, Calò PG, Hellmann A, Di Filippo G, Karakozis L, Chrisoulidou A, Gamgaram VKD, Sriphrapradang C, Leclère JC, Orois A, Marco D, Dhiwakar M, de Pasquale L, Buemi A, Nesti C, Pandev R, Chala A, Yalıman SS, Hajiioannou J, Liu SYW, Cherenko S, Voloudakis N, Koutelidakis I, Nastos K, Constanza R, Dobrinja C, Brunner M, Bains L, Panchangam RB, Girardi FM, Arikan AE, El Malki HO, de Cillia M, Oragano L, Pliakos I, Moysidis M, Pennestrì F, De Crea C, Čukman M, Tarle A, Senashova OS, Shindo ML, Tüzken İ, Turhan MA, Varaldo E, Albertelli M, Medas F, Canu GL, Cappellacci F, Śledziński M, Lazzari G, Morelli E, Karakozis S, Boudina M, Katsamakas M, Guevara MI, Aroonroch R, Manyalich M, Vidal O, Triponez F, Masse N, Kathirvel L, Muthusamy R, La Rubia P, Castellani L, Maria-Cristina B, Raluca-Maria F, Kaderli R, Teksoz S, Chow TCM, Lai MS, Shchekaturova L, Bellou E, Banus M, Da Milano R, Mastronardi M, Grützmann R, Hauth LA, Abentroth AL, Dulgeroglu O, Uras C, Placentino G, Leutner M (2026)

Publication Type: Journal article

Publication year: 2026

Journal

DOI: 10.1007/s13304-025-02513-6

Abstract

Medullary thyroid carcinoma (MTC) is a rare, but biologically aggressive cancer that accounts for 1–2% of all thyroid malignancies. Its aggressiveness has been linked to distinct clinicopathological features. Novel pathological predictors of aggressiveness have also been described in the literature. However, these remain contentious, to date. To assess the prognosticators of aggressiveness for MTC and establish potentially novel ones. The primary endpoint was to establish predictors for central and/or lateral cervical nodal metastatic disease. Whereas secondary endpoints include defining biochemical and histopathologic markers of aggressiveness. A multi-center retrospective analysis of prognosticators of aggressiveness in MTC. 785 patients with MTC were enrolled. The mean age was 56 years with a female to male ratio of 1: 1.7. Regression analysis demonstrated that aggressive prognosticator predictive of nodal metastasis included: age, pre- and post-operative Calcitonin and CEA levels, tumor size, multifocality, capsular and lymphovascular invasion, the presence of extrathyroidal extension, Ki-67, and RET positivity, desmoplasia, and inflammatory scores. This study provides an expanded spectrum of prognosticators of tumor aggressiveness. Furthermore, it also highlights the potential meaningful therapeutic implications of preoperative inflammatory scores, tumor desmoplastic reaction, and metastatic nodal ratio.

Authors with CRIS profile

Involved external institutions

Theageneio Hospital of Thessaloniki / Theagenio Cancer Hospital of Thessaloniki / Θεαγένειο Αντικαρκινικό Νοσοκομείο Θεσσαλονίκης Greece (GR) AHEPA University General Hospital / Πανεπιστημιακό Νοσοκομείο ΑΧΕΠΑ Greece (GR) Hospital Regional de Málaga Spain (ES) Università degli Studi di Cagliari Italy (IT) Mohammed V University (UMVA) / جامعة محمد الخامس‎ Morocco (MA) University Hospital of Verona / Azienda Ospedaliera Universitaria Integrata Verona (AOUI) Italy (IT) Centre hospitalier universitaire de Brest (CHRU Brest) France (FR) Ankara University / Ankara Üniversitesi Turkey (TR) Hashemite University (HU) / الجامعة الهاشمية Jordan (JO) Hospital Clínic de Barcelona Spain (ES) Kovai Medical Center and Hospital (KMCH) India (IN) Hospital Privado Argentina (AR) Cliniques universitaires Saint-Luc (CHU St-Luc) Belgium (BE) University of Genova / Università degli Studi di Genova Italy (IT) Fondazione Policlinico Universitario Agostino Gemelli IRCCS Italy (IT) Hospital Ana Nery Brazil (BR) Bhargav Endocrine Hospital India (IN) The Chinese University of Hong Kong (CUHK) China (CN) Università degli Studi di Trieste Italy (IT) Inselspital, Universitätsspital Bern Switzerland (CH) General State Hospital "Georgios Gennimatas" / Γενικό Κρατικό Νοσοκομείο Αθηνών «Γεώργιος Γεννηματάς» Greece (GR) Medical University Sofia / Медицински университет Bulgaria (BG) Sisters of Charity Hospital / Klinički Bolnički Centar Sestre Milosrdnice (KBCSM) Croatia (HR) Istanbul University Cerrahpaşa / İstanbul Üniversitesi Cerrahpaşa (IUC) Turkey (TR) General University Hospital of Larissa Greece (GR) Ospedale San Biagio Italy (IT) Evgenidion Clinic Agia Trias S.A. Greece (GR) CitiDoctor - International Medical Center Kyiv Ukraine (UA) Geneva University Hospitals / Hôpitaux universitaires de Genève (HUG) Switzerland (CH) Oregon Health and Science University (OSHU) United States (USA) (US) Medical University Gdansk / Gdański Uniwersytet Medyczny Poland (PL) Maulana Azad Medical College (MAMC) India (IN) Thien Hanh Hospital / Bệnh viện Đa khoa Thiện Hạnh Viet Nam (VN) Acıbadem Üniversitesi Turkey (TR) Universidad de Caldas / Caldas University Colombia (CO) Ramathibodi Hospital / โรงพยาบาลรามาธิบดี Thailand (TH)

How to cite

APA:

Papavramidis, T., Chorti, A., Bakkar, S., Raffaelli, M., Košec, A., Hoang, V.T.,... Leutner, M. (2026). MYELOstudy: lymph node stage of aggressiveness in medullary thyroid cancer—a retrospective multi-center study analysis. Updates in Surgery. https://doi.org/10.1007/s13304-025-02513-6

MLA:

Papavramidis, Theodossis, et al. "MYELOstudy: lymph node stage of aggressiveness in medullary thyroid cancer—a retrospective multi-center study analysis." Updates in Surgery (2026).

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