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Results of Surgical Therapy in Patients with Medullary Thyroid Carcinoma

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Abstract

Medullary thyroid carcinoma (MTC) is a rare form of malignancy, having an intermediate prognosis. Controversies exist regarding the best surgical approach. The aim of the study was to analyze the outcome in a group of patients with MTC, diagnosed and followed up in a single care center. We performed a retrospective analysis of all the patients diagnosed with MTC in the Department of Endocrinology from the County Emergency Hospital Timisoara between 1992 and 2012. The study group included 19 patients, 6 men (31.6 %), mean age 41.2 ± 12.5 years (20–72 years). The preoperative diagnosis was based on the protocol for nodular thyroid disease. Total or near-total thyroidectomy was performed in 10 out of 16 patients who could be operated. Postoperative follow-up included repeated measurements of serum calcitonin and imaging investigations. Nine out of the total of 19 (47.3 %) patients had hereditary forms of MTC. Most of the cases (84.2 %) were submitted to surgery. The median duration of follow-up was 84 months. The pTNM staging indicated that the majority of the patients with hereditary MTC were diagnosed in an earlier stage. Disease remission was achieved in 7 cases (43.8 %). Four patients, all with sporadic forms, died. Survival rates at 1, 5 and 10 years were significantly higher (p = 0.048) in patients with hereditary MTC. An early diagnosis of MTC allows a better surgical approach and an improved survival rate. We support the general recommendation that modified radical neck dissection is not necessary for all the patients with MTC.

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References

  1. Matias-Guiu X, De Lellis R (2014) Medullary thyroid carcinoma: a 25-year perspective. Endocr Pathol 25:21–29. doi:10.1007/s12022-013-9287-2

    Article  CAS  PubMed  Google Scholar 

  2. Schlumberger MJ, Filetti S, Hay ID (2008) Nontoxic diffuse and nodular goiter and thyroid neoplasia. In: Kronenberg HM, Melmed S, Polonsky KS, Reed Larsen P (eds) Williams textbook of endocrinology, 11th edn. Saunders Elsevier, Philadelphia, pp 411–442

    Google Scholar 

  3. Grozinsky-Glasberg S, Benbassat CA, Tsvetov G, Feinmesser R, Hava Peretz H, Shimon I, Lapidot M (2007) Medullary thyroid cancer: a retrospective analysis of a cohort treated at a single tertiary care center between 1970 and 2005. Thyroid 17:549–556

    Article  PubMed  Google Scholar 

  4. American Thyroid Association Guidelines Task Force, Kloos RT, Eng C, Evans DB, Francis GL, Gagel RF, Gharib H, Moley JF, Pacini F, Ringel MD, Schlumberger M, Wells SA Jr (2009) Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid 19:565–612. doi:10.1089/thy.2008.0403

    Article  Google Scholar 

  5. Schlumberger M, Bastholt L, Dralle H, Jarzab B, Pacini F, Smit JWA, The European Thyroid Association Task Force (2012) 2012 European Thyroid Association guidelines for metastatic medullary thyroid cancer. Eur Thyroid J 1:5–14. doi:10.1056/NEJMoa1108586

    Article  PubMed Central  Google Scholar 

  6. Duntas LH (2013) Clinical comments related to medullary thyroid cancer diagnosis and management. Thyroid Res 6(Suppl 1):S6. doi:10.1186/1756-6614-6-S1-S6

    PubMed  PubMed Central  Google Scholar 

  7. Yen TW, Shapiro SE, Gagel RF, Sherman SI, Lee JE, Evans DB (2003) Medullary thyroid carcinoma: results of a standardized surgical approach in a contemporary series of 80 consecutive patients. Surgery 134:890–899

    Article  PubMed  Google Scholar 

  8. Moley JF, DeBenedetti MK (1999) Patterns of nodal metastases in palpable medullary thyroid carcinoma: recommendations for extent of node dissection. Ann Surg 229:880–887

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Roh JL, Park JY, Park CI (2007) Total thyroidectomy plus neck dissection in differentiated papillary thyroid carcinoma patients: pattern of nodal metastasis, morbidity, recurrence, and postoperative levels of serum parathyroid hormone. Ann Surg 245:604–610

    Article  PubMed  PubMed Central  Google Scholar 

  10. Wong KP, Lang BH (2011) The role of prophylactic central neck dissection in differentiated thyroid carcinoma: issues and controversies. J Oncol 2011:127929. doi:10.1155/2011/127929

    Article  PubMed  PubMed Central  Google Scholar 

  11. Greene FL, Page DL, Fleming ID, Fritz A, Balch DM (2003) AJCC cancer staging manual, 6th edn. Springer Verlag, Chicago

    Google Scholar 

  12. Boostrom SY, Grant CS, Thompson GB, Farley DR, Richards ML, Hoskin TL, Hay ID (2009) Need for a revised staging consensus in medullary thyroid carcinoma. Arch Surg 144:663–669. doi:10.1001/archsurg.2009.122

    Article  PubMed  Google Scholar 

  13. Gülben K, Berberoğlu U, Boyabatli M (2006) Prognostic factors for sporadic medullary thyroid carcinoma. World J Surg 30:84–90

    Article  PubMed  Google Scholar 

  14. Clark JR, Fridman TR, Odell MJ, Brierley J, Walfish PG, Freeman JL (2005) Prognostic variables and calcitonin in medullary thyroid cancer. Laryngoscope 115:1445–1450

    Article  CAS  PubMed  Google Scholar 

  15. Rendl G, Manzl M, Hitzl W, Sungler P, Pirich C (2008) Longterm prognosis of medullary thyroid carcinoma. Clin Endocrinol 69:497–505. doi:10.1111/j.1365-2265.2008.03229.x

    Article  CAS  Google Scholar 

  16. Hyer SL, Vini L, A’Hern R, Harmer C (2000) Medullary thyroid cancer: multivariate analysis of prognostic factors influencing survival. Eur J Surg Oncol 26:686–690

    Article  CAS  PubMed  Google Scholar 

  17. Dottorini ME, Assi A, Sironi M, Sangalli G, Spreafico G, Colombo L (1996) Multivariate analysis of patients with medullary thyroid carcinoma. Prognostic significance and impact on treatment of clinical and pathologic variables. Cancer 77:1556–1565

    Article  CAS  PubMed  Google Scholar 

  18. Kebebew E, Ituarte PH, Siperstein AE, Duh QY, Clark OH (2000) Medullary thyroid carcinoma: clinical characteristics, treatment, prognostic factors, and a comparison of staging systems. Cancer 88:1139–1148

    Article  CAS  PubMed  Google Scholar 

  19. Ito Y, Miyauchi A, Yabuta T, Fukushima M, Inoue H, Tomoda C, Uruno T, Kihara M, Higashiyama T, Takamura Y, Miya A, Kobayashi K, Matsuzuka F (2009) Alternative surgical strategies and favorable outcomes in patients with medullary thyroid carcinoma in Japan: experience of a single institution. World J Surg 33:58–66. doi:10.1007/s00268-008-9795-2

    Article  PubMed  Google Scholar 

  20. de Groot JW, Plukker JT, Wolffenbuttel BH, Wiggers T, Sluiter WJ, Links TP (2006) Determinants of life expectancy in medullary thyroid cancer: age does not matter. Clin Endocrinol (Oxf) 65:729–736

    Article  Google Scholar 

  21. O’Riordain DS, O’Brien T, Weaver AL, Gharib H, Hay ID, Grant CS, van Heerden JA (1994) Medullary thyroid carcinoma in multiple endocrine neoplasia types 2A and 2B. Surgery 116:1017–1023

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Endocrinology, “Victor Babes” University of Medicine and Pharmacy, Piata Eftimie Murgu nr. 2, 300041, Timisoara, Romania

    Mihaela Vlad & Ioana Zosin

  2. Department of Biostatistics and Medical Informatics, “Victor Babes” University of Medicine and Pharmacy, Piata Eftimie Murgu nr. 2, 300041, Timisoara, Romania

    Bogdan Timar

  3. The Second Surgery Department, “Victor Babes” University of Medicine and Pharmacy, Piata Eftimie Murgu nr. 2, 300041, Timisoara, Romania

    Fulger Lazar

  4. Department of Diabetes and Metabolic Diseases, “Victor Babes” University of Medicine and Pharmacy, Piata Eftimie Murgu nr. 2, 300041, Timisoara, Romania

    Adrian Vlad & Romulus Timar

  5. Department of Pathology, “Victor Babes” University of Medicine and Pharmacy, Piata Eftimie Murgu nr. 2, 300041, Timisoara, Romania

    Marioara Cornianu

Authors
  1. Mihaela Vlad
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  2. Ioana Zosin
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  3. Bogdan Timar
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  4. Fulger Lazar
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  5. Adrian Vlad
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  6. Romulus Timar
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  7. Marioara Cornianu
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Corresponding author

Correspondence to Adrian Vlad.

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This study received no financial support. For this type of study, formal consent is not required. All the procedures related to the study were approved by the local ethics committee of the hospital.

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The authors declare that they have no competing interests.

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Vlad, M., Zosin, I., Timar, B. et al. Results of Surgical Therapy in Patients with Medullary Thyroid Carcinoma. Indian J Surg 78, 309–314 (2016). https://doi.org/10.1007/s12262-015-1386-5

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  • DOI: https://doi.org/10.1007/s12262-015-1386-5

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