Endocrinol Metab.  2020 Dec;35(4):811-819. 10.3803/EnM.2020.709.

Trends in the Diagnosis and Treatment of Patients with Medullary Thyroid Carcinoma in Korea

Affiliations
  • 1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
  • 2Department of Biostatistics, Korea University College of Medicine, Seoul, Korea
  • 3Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
  • 4Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 5Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

Abstract

Background
Thyroid cancer is becoming increasingly common worldwide, but little is known about the epidemiology of medullary thyroid carcinoma (MTC). This study investigated the current status of the incidence and treatment of MTC using Korean National Health Insurance Service (NHIS) data for the entire Korean population from 2004 to 2016.
Methods
This study included 1,790 MTC patients identified from the NHIS database.
Results
The age-standardized incidence rate showed a slightly decreasing or stationary trend during the period, from 0.25 per 100,000 persons in 2004 to 0.19 in 2016. The average proportion of MTC among all thyroid cancers was 0.5%. For initial surgical treatment, 65.4% of patients underwent total thyroidectomy. After surgery, external-beam radiation therapy (EBRT) was performed in 10% of patients, a proportion that increased from 6.7% in 2004 to 11.0% in 2016. Reoperations were performed in 2.7% of patients (n=49) at a median of 1.9 years of follow-up (interquartile range, 1.2 to 3.4). Since November 2015, 25 (1.4%) patients with MTC were prescribed vandetanib by December 2016.
Conclusion
The incidence of MTC decreased slightly with time, and the proportion of patients who underwent total thyroidectomy was about 65%. EBRT, reoperation, and tyrosine kinase inhibitor therapy are additional treatments after initial surgery for advanced MTC in Korea.

Keyword

Epidemiology; Incidence; Thyroid cancer; medullary; Therapeutics
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