A Retrospective Review of the Multidisciplinary Management of Medullary Thyroid Cancer.
Bibliographic record
Abstract
e17551 Background: Medullary thyroid carcinoma (MTC) accounts for 4-10% of all thyroid cancers. Our aim was to review the treatment of MTC and the effect of newer therapies on patient outcomes. Methods: The British Columbia Cancer Agency (BCCA) provides cancer care to a population of 4.3 million people. A retrospective chart review was conducted of all patients with MTC referred to the BCCA from 1998 to 2014. Clinical characteristics, pathology and outcome data were collected. DFS and OS were determined for patients based on staging and treatment. Results: Of the 98 patients referred to the BCCA during the study period, the median age of diagnosis was 54 years (range 10-95). Inherited mutations were found in 6% and 60% did not receive genetic testing. Based on clinical SEER staging, there were 50% localized, 38% regional, and 12% distant cases. Among the 77% of patients who had complete surgical resection, 25% received adjuvant radiation therapy. Median DFS for clinical SEER stage: localized 18.97 years and regional 6.52 years (p = 0.028). Initial treatment of 23 patients with unresectable/metastatic disease consisted of: 2 surgery only, 4 radiation only, 11 surgery and radiation, 3 radiation and chemotherapy, 1 trimodality and 2 best supportive care. In the 9 patients who received one or more course of chemotherapy, there were variations in the initial regimen: 2 cisplatin/etoposide, 2 sunitinib, 3 sorafenib, 1 vandetanib, 1 adriamycin. Median overall survival based on clinical SEER stage: localized 19.93 years, regional 16.09 years, and distant 0.93 years (p < 0.001). Median OS for all patients was 16.10 yrs. Conclusions: MTC has a good prognosis with a long median OS. Treatment patterns reflect multidisciplinary management based on patients disease characteristics. Only 10% of patients required systemic therapy at some point during their disease trajectory.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".