ArticleJournal of clinical oncology : official journal of the American Society of Clinical Oncology2022
International Medullary Thyroid Carcinoma Grading System: A Validated Grading System for Medullary Thyroid Carcinoma.
Article in Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 73 papers, 1 of them a synthesis that pooled it.
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Who cites it
73 citing papers in PubMed, 1 synthesis or guideline pooled it, 128 citations in OpenAlex.
- The 2024 revised clinical guidelines on the management of thyroid tumors by the Japan Association of Endocrine Surgery.Endocrine journal · 2025Guideline
- Covalent FAPI Imaging-Guided Precision Surgery in Patients with Medullary Thyroid Carcinoma: A Phase II Clinical Trial.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026Trial
- Beyond Tumor Diameter: Exploratory Cohort-Derived Calcitonin Secretory Categories and Invasive Pathology in Medullary Thyroid Carcinoma.Current oncology (Toronto, Ont.) · 2026Article
- Knowledge gaps in tubular gut tumours: a critical appraisal of the 6th edition of the World Health Organization classification of tumours.The Journal of pathology · 2026Review
- Immunohistochemical expression of Ki-67, INSM1, and SSTR2A in medullary thyroid carcinoma: correlation with tumour size, vascular invasion, and biochemical outcome.Virchows Archiv : an international journal of pathology · 2026Article
- Grading medullary thyroid carcinoma on fine needle aspiration biopsy specimens: a comparative study between manual counting and a deep learning platform.Journal of the American Society of Cytopathology · 2026Article
- FROM DISCOVERY SCIENCE TO THE CLINIC - HERITABLE ENDOCRINE CANCERS AND RELATED DISORDERS: Functional imaging in hereditary endocrine neoplasms: evolving modalities and clinical implications.Endocrine-related cancer · 2026Review
- Prognostic Factors in Medullary Thyroid Cancer: A Real-World Study in a Referral Center.Biomedicines · 2026Article
- Article
- Surgical extent, tumor size, and calcitonin levels in medullary thyroid carcinoma: impact on oncologic outcomes in a retrospective cohort study.BMC cancer · 2026Article
- Three-Tier Prognostic Stratification of Lung Carcinoids (NET G1-G2-G3) by Multivariable, Data-Driven Integration of Ki-67 and Mitotic Count.Endocrine pathology · 2026Article
- Somatic genomic profiling reveals clinically relevant heterogeneity inJournal of clinical & translational endocrinology · 2026Article
- Diagnostic Utility of Ki-67 Index on Cell Block Material for Grading Medullary Thyroid Carcinoma.Diagnostic cytopathology · 2026Article
- Clinical pathological characteristics and prognostic analysis of 140 cases of medullary thyroid carcinoma: validation of the international medullary thyroid carcinoma grading system in a chinese cohort.Diagnostic pathology · 2026Article
- Article
- Multi-center multi-omics integration predicts individualized prognosis in medullary thyroid carcinoma.Nature communications · 2026Article
- State of the Art on Thyroid Cancer Biology and Oncology.Biomedicines · 2026Review
- Development and validation of a predictive model for extranodal natural killer/T-cell lymphoma.NPJ digital medicine · 2026Article
- Ultrasound-guided, nursing-led, phase-based swallowing rehabilitation in elderly patients with MIBG-positive medullary thyroid carcinoma followingFrontiers in medicine · 2026Article
- How to manage medullary thyroid carcinoma: current treatment strategies.Drugs in context · 2026Review
13 more citing papers are in PubMed but not listed here.
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Authors and funding
27 authors at 5 institutions in 4 countries.
Funding
Abstract
purposeMedullary thyroid carcinoma (MTC) is an aggressive neuroendocrine tumor (NET) arising from the calcitonin-producing C cells. Unlike other NETs, there is no widely accepted pathologic grading scheme. In 2020, two groups separately developed slightly different schemes (the Memorial Sloan Kettering Cancer Center and Sydney grade) on the basis of proliferative activity (mitotic index and/or Ki67 proliferative index) and tumor necrosis. Building on this work, we sought to unify and validate an internationally accepted grading scheme for MTC. PATIENTS AND
methodsTumor tissue from 327 patients with MTC from five centers across the United States, Europe, and Australia were reviewed for mitotic activity, Ki67 proliferative index, and necrosis using uniform criteria and blinded to other clinicopathologic features. After reviewing different cutoffs, a two-tiered consensus grading system was developed. High-grade MTCs were defined as tumors with at least one of the following features: mitotic index ≥ 5 per 2 mm
resultsEighty-one (24.8%) MTCs were high-grade using this scheme. In multivariate analysis, these patients demonstrated decreased overall (hazard ratio [HR] = 11.490; 95% CI, 3.118 to 32.333;
conclusionThis simple two-tiered international grading system is a powerful predictor of adverse outcomes in MTC. As it is based solely on morphologic assessment in conjunction with Ki67 immunohistochemistry, it brings the grading of MTCs in line with other NETs and can be readily applied in routine practice. We therefore recommend grading of MTCs on the basis of mitotic count, Ki67 proliferative index, and tumor necrosis.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.