Letter to the Editor: “Medullary Thyroid Carcinoma in MEN2A: ATA Moderate- or High-Risk RET Mutations Do Not Predict Disease Aggressiveness”

摘要

We thank Voss et al. (1) for their interesting study about the overall outcome of patients with moderate- and high-risk multiple endocrine neoplasia type 2 (MEN2A). The authors compared the mortality and time to distant metastases in patients carrying moderate- and high-risk (634 codon) mutations of RET, and they did not observe any significant difference. They recommend modifying the schematic of the American Thyroid Association classification by replacing moderate and high risk with “late” and “early disease onset.” This is of importance as it is the first time that the idea of parallel survival curves is suggested, the only difference being the time of disease onset. We would like to share two main concerns about this study, and the reasons why we think this new terminology might be premature.