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David S McLaren Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospital NHS Trust, Leeds, UK

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Aarani Devi Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospital NHS Trust, Leeds, UK

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Nikolaos Kyriakakis Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospital NHS Trust, Leeds, UK

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Michelle Kwok-Williams Clinical Oncology, Leeds Cancer Centre, Leeds Teaching Hospital NHS Trust, Leeds, UK

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Robert D Murray Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds Teaching Hospital NHS Trust, Leeds, UK
Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM), University of Leeds, Leeds, UK

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many childhood cancers requiring radiation therapy to induce remission. Current data support at least the equivalence of PBT to photon-based therapies in terms of recurrence-free survival and overall survival. Although the dosimetric studies are

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Anne Jouinot Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France
Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, France

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Bernard Royer CHU Besançon, Clinical Pharmacology and Toxicology Dpt, Besançon cedex, France

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Etienne Chatelut Institut Claudius-Regaud, Université de Toulouse, INSERM, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France

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Sotheara Moeung Institut Claudius-Regaud, Université de Toulouse, INSERM, Centre de Recherches en Cancérologie de Toulouse, Toulouse, France

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Guillaume Assié Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
Department of Endocrinology, Center for Rare Adrenal Diseases, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France

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Audrey Thomas-Schoemann Department of Pharmacy, Cochin Hospital, Paris Descartes University, AP-HP, Paris, France
Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, AP-HP, Paris, France

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Jérôme Bertherat Institut Cochin, INSERM U1016, CNRS UMR8104, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
Department of Endocrinology, Center for Rare Adrenal Diseases, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France

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François Goldwasser Department of Medical Oncology, Cochin Hospital, Paris Descartes University, CARPEM, AP-HP, Paris, France

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Benoit Blanchet Pharmacokinetics and Pharmacochemistry Unit, Cochin Hospital, Paris Descartes University, AP-HP, Paris, France
UMR8638 CNRS, Pharmacy UFR, University of Paris Descartes, PRES sorbonne Paris Cité, Paris, France

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progression-free survival (5 months) remain disappointing. Furthermore, lower rates of severe hematological toxicities are observed with EDP-mitotane regimen than with platinum-etoposide in small-cell lung cancer (SCLC) patients (11 vs 53% of grade 3

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Magdalena Lech Faculty of Life Sciences and Medicine, School of Life Course Sciences, King’s College London, London, UK

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Ruvini Ranasinghe Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Royce P Vincent Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK
Faculty of Life Sciences and Medicine, School of Life Course Sciences, King’s College London, London, UK

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David R Taylor Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Lea Ghataore Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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James Luxton Department of Clinical Biochemistry, King’s College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Fannie Lajeunesse-Trempe Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
Quebec Heart and Lung Institute, Laval University, Quebec, Canada

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Pia Roser Department of Endocrinology and Diabetes, University Medical Centre Hamburg Eppendorf, Hamburg, Germany

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Eftychia E Drakou Department of Clinical Oncology, Guy's Cancer Centre - Guy's and St Thomas' NHS Foundation Trust, Great Maze Pond, London, UK

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Ling Ling Chuah Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Ashley B Grossman Green Templeton College, University of Oxford, Oxford, UK
Barts and the London School of Medicine, Centre for Endocrinology, William Harvey Institute, London, UK
Neuroendocrine Tumour Unit, Royal Free Hospital, London, UK

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Simon J B Aylwin Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK

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Georgios K Dimitriadis Department of Endocrinology ASO/EASO COM, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK
Obesity, Type 2 Diabetes and Immunometabolism Research Group, School of Cardiovascular and Metabolic Medicine & Sciences, Faculty of Life Course Sciences, King’s College London, London, UK
Division of Reproductive Health, Warwick Medical School, University of Warwick, Coventry, UK

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frequently reported are generalised symptoms of cancer such as cachexia, night sweats and fever ( 3 ). The prognosis of ACC is generally poor, with a median overall survival of 3–4 years ( 2 ). Currently, the only curative treatment is surgery. The current

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Michael Ulm University of Tennessee Health Science Center, Memphis, Tennessee, USA
West Cancer Center, Memphis, Tennessee, USA

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Arvind V Ramesh White Station High School, Memphis, Tennessee, USA

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Keely M McNamara Tohoku University, Miyagi, Japan

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Suriyan Ponnusamy University of Tennessee Health Science Center, Memphis, Tennessee, USA

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Hironobu Sasano Tohoku University, Miyagi, Japan

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Ramesh Narayanan University of Tennessee Health Science Center, Memphis, Tennessee, USA
West Cancer Center, Memphis, Tennessee, USA

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therapeutics to treat these cancers has substantially increased. These new treatment options, though extended the progression-free and overall survival, have also contributed to more resistant and aggressive disease variants. For example, although undisputedly

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Thera P Links Division of Endocrinology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands

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Trynke van der Boom Division of Endocrinology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands

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Wouter T Zandee Division of Endocrinology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands

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Joop D Lefrandt Division of Vascular Medicine, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands

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and higher prevalence of cervical lymph nodes and distant (mostly pulmonary) metastases, and show a higher recurrence rate compared to adults ( 27 , 28 ). Nevertheless, their prognosis is even better than that of adults, with 15-year survival rates

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C Sui Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun City, China

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Q He Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun City, China

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R Du Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun City, China

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D Zhang Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun City, China

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F Li Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun City, China

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G Dionigi Division for Endocrine and Minimally Invasive Surgery, Department of Human Pathology in Adulthood and Childhood ‘G. Barresi’, University Hospital ‘G. Martino’, The University of Messina, Messina, Italy

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N Liang Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun City, China

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H Sun Division of Thyroid Surgery, China-Japan Union Hospital of Jilin University, Jilin Provincial Key Laboratory of Surgical Translational Medicine, Jilin Provincial Precision Medicine Laboratory of Molecular Biology and Translational Medicine on Differentiated Thyroid Carcinoma, Changchun City, China

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-specific mortality; DSM, disease-specific mortality; DSS, disease-specific survival; EFS, event free survival; LNs, lymph nodes; Location of positive LNs, N1a and N1b; NR, lymph node ratio; OS, overall survival. In the current study, we examined the

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Kosmas Daskalakis Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
1st Department of Propaupaedic Internal Medicine, Endocrine Unit, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece

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Marina Tsoli 1st Department of Propaupaedic Internal Medicine, Endocrine Unit, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece

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Anna Angelousi 1st Department of Propaupaedic Internal Medicine, Endocrine Unit, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece

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Evanthia Kassi 1st Department of Propaupaedic Internal Medicine, Endocrine Unit, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece

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Krystallenia I Alexandraki 1st Department of Propaupaedic Internal Medicine, Endocrine Unit, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece

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Denise Kolomodi 1st Department of Propaupaedic Internal Medicine, Endocrine Unit, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece

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Gregory Kaltsas 1st Department of Propaupaedic Internal Medicine, Endocrine Unit, Laiko Hospital, National and Kapodistrian University of Athens, Athens, Greece
Clinical Sciences Research Laboratories, Warwick Medical School, University of Warwick, University Hospital, Coventry, UK
Centre of Applied Biological & Exercise Sciences, Faculty of Health & Life Sciences, Coventry University, Coventry, UK

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Anna Koumarianou Haematology-Oncology Unit, Fourth Department of Internal Medicine, Attikon University General Hospital, National and Kapodistrian University of Athens, Athens, Greece

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index (KI67) ( 7 , 8 ). Everolimus interacts with the MTOR pathway and related intracellular pathways, suppressing downstream multi-protein complexes and increasing progression-free survival (PFS) across different sets of NENs ( 9 , 10 , 6 , 3 ). On

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Emily Warmington Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK

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Gabrielle Smith Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK

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Vasileios Chortis Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK

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Raimunde Liang Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany
Department of Neurosurgery, Technical University Munich (TMU), Munich, Germany

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Juliane Lippert Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany

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Sonja Steinhauer Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany

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Laura-Sophie Landwehr Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany

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Constanze Hantel Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland
Medizinische Klinik Und Poliklinik III, University Hospital Carl Gustav Carus, Dresden, Germany

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Katja Kiseljak-Vassiliades Division of Endocrinology Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA

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Margaret E Wierman Division of Endocrinology Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA

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Barbara Altieri Division of Endocrinology and Diabetes, University Hospital of Wuerzburg, Wuerzburg, Germany

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Paul A Foster Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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Cristina L Ronchi Institute of Metabolism and System Research, University of Birmingham, Birmingham, UK
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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of patients; R0, complete resection; R1, microscopic incomplete resection; R2, macroscopic incomplete resection; RX, uncertain resection. The clinical outcome of patients with ACC was assessed by overall survival (OS) and progression-free

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Erika Urbano Lima Biological Science Department, Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
Structural and Functional Biology Program, Universidade Federal de São Paulo, São Paulo, Brazil

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Ileana G S Rubio Biological Science Department, Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil
Structural and Functional Biology Program, Universidade Federal de São Paulo, São Paulo, Brazil

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Joaquim Custodio Da Silva Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
Post-graduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, Brazil

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Ana Luiza Galrão Biological Science Department, Thyroid Molecular Sciences Laboratory, Universidade Federal de São Paulo, São Paulo, Brazil

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Danielle Pêssoa Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
Post-graduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, Brazil

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Taise Cerqueira Oliveira Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil

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Fabiane Carrijo Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
Post-graduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, Brazil

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Igor Silva Campos Department of Pathology, Sao Rafael Hospital, Salvador, Brazil

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Luciano Fonseca Espinheira Department of Pathology, Sao Rafael Hospital, Salvador, Brazil
Department of Anatomic Pathology & Legal Medicine, Bahia Federal Medical School, Federal University of Bahia, Salvador, Brazil

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Luiz Jose Sampaio Nuclear Medicine Department, Sao Rafael Hospital, Salvador, Brazil

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Claudio Rogerio Lima Head and Neck Surgery Department, Sao Rafael Hospital, Salvador, Brazil

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Janete Maria Cerutti Structural and Functional Biology Program, Universidade Federal de São Paulo, São Paulo, Brazil
Division of Genetics, Department of Morphology and Genetics, Genetic Basis of Thyroid Tumors Laboratory, Paulista School of Medicine, Universidade Federal de São Paulo, São Paulo, Brazil

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Helton Estrela Ramos Department of Bio-regulation, Thyroid Study Laboratory, Health & Science Institute, Federal University of Bahia, Salvador, Brazil
Post-graduate Program in Interactive Processes of Organs and Systems, Health & Science Institute, Federal University of Bahia, Salvador, Brazil

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-methylation correlated with older age (≥45 years) ( P  < 0.001) and with follicular variant ( P  = 0.002). Kaplan–Meier survival analysis showed significant association of hyper-methylation with worse overall survival ( P  = 0.003), worse disease free status ( P  = 0

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Nicola Tufton Department of Endocrinology, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
Centre for Endocrinology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

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Lucy Shapiro Centre for Endocrinology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Department of Paediatric Endocrinology, Royal London Hospital, Barts Health NHS Trust, London, UK

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Anju Sahdev Department of Radiology, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK

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Ajith V Kumar North East Thames Regional Genetics Service, Great Ormond Street Hospital, London, UK

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Lee Martin Department of Paediatric Endocrinology, Royal London Hospital, Barts Health NHS Trust, London, UK

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William M Drake Department of Endocrinology, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
Centre for Endocrinology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

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Scott A Akker Department of Endocrinology, St Bartholomew’s Hospital, Barts Health NHS Trust, London, UK
Centre for Endocrinology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK

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Helen L Storr Centre for Endocrinology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Department of Paediatric Endocrinology, Royal London Hospital, Barts Health NHS Trust, London, UK

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. Urine metanephrine:creatinine ratio was measured on spot urine samples. Plasma metanephrines (free fractionated) were analysed by LC-MS/MS. Age-specific reference ranges were used for spot urine metanephrine:creatinine ratio and plasma metanephrine

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