How Tumor Grade Predicts Outcomes in MTC Resection with Dr. Nigam

Описание: We are honored to have Dr. Aradhya Nigam present "Tumor Grade Predicts for Calcitonin Doubling Times and Disease Specific Outcomes after Resection of MTC." Dr. Margaret Brandwein-Weber joins as the featured expert discussant.

0:00 Webinar

2:04 Dr. Nigam presents

3:00 A New Grading System for MTC
Dr. Nigam introduces his group’s international effort for developing a new grading system for medullary thyroid carcinoma in order to better predict outcomes and change management for pts with more aggressive versus less aggressive medullary thyroid carcinoma (MTC). The work led to the development of clinical applications for this grading system. This involved the identification of prognostic factors associated with recurrence and survival to predict post-operative outcomes based on histologic grading. Factors such as necrosis, mitotic index, and Ki67 proliferation index were evaluated to form a highly accurate two-tier grading system for medullary thyroid cancer.

8:30 Surveillance of MTC by Grading
Dr. Nigam advocates for the calculation of calcitonin and CEA doubling times, which are validated biomarkers for detecting MTC recurrence and poor outcomes. Calcitonin and CEA doubling times were found to be associated with recurrence and survival, with lower doubling times within two years being the accepted marker of worse outcomes across the board. Dr. Nigam and his team aimed to understand a correlation between grade and CEA & calcitonin doubling times and the subsequent effects on disease-specific outcomes such as local recurrence, distant recurrence, and survival. These implications may inform surveillance strategies, recurrence prediction, and identification of high risk cohorts, and treatment regimens. High-grade patients compared to low-grade had significantly faster doubling times. Ultimately, grade and doubling times when taken together can be used to determine surveillance strategies.

29:29 Dr. Brandwein-Weber presents

30:00 The Histological Landscape of MTC
Dr. Brandwein discusses the layout of histopathologic evaluation of MTC, which include analysis of Ki67 proliferative index, mitotic index, and necrosis. She introduces a multi-center international study across the US, Europe, and Australia to advocate for further clarification to recommend a more comprehensive pathology grading scheme for better patient outcomes. She underscores the overall rarity of MTC as a limiting factor for developing a standard grading system. Nevertheless, calcitonin doubling time remains a valuable predictor of tumor grade and disease status.

40:44 Discussion with Q&A

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