Results of surgical treatment of sporadic medullary thyroid carcinoma following routine measurement of serum calcitonin.
OBJECTIVE
The aim of this study was to evaluate the results of the surgical management of medullary thyroid carcinoma (MTC), following the introduction of systematic calcitonin measurement in patients referred for thyroid diseases.


METHODS
We included all the patients with elevated calcitonin and MTC from January 1993 to March 2001.


RESULTS
Among 8497 patients, MTC was diagnosed in 52 with a mean age of 56.1 years. Thirty-two fine needle biopsies led to diagnose MTC in 19 cases. The median basal pre-operative calcitonin level was 245 pg/ml. Elevated calcitonin serum was the only indicator of MTC in 31 patients. Fifty-one patients underwent total thyroidectomies, with lymphadenectomy in 45. Thirteen patients had lymph node involvement. Post-operatively, 40 (77%) had normal basal and pentagastrin (Pg) stimulated calcitonin serum levels, and remained normal at a mean follow-up of 5.16 years (1.8-8).


CONCLUSIONS
Routine pre-operative measurement of calcitonin should be performed because it is often the only indicator of MTC at an early stage. This could lead to an improved MTC cure rate.
Department of General and Endocrine Surgery, University Hospital La Timone, Boulevard Jean Moulin, 13385 Marseille 05, France. eric.mirallie@chu-nantes.fr
E
E
Mirallié
M
M
Iacobone
F
F
Sebag
J F
JF
Henry
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002116:Calcitonin / Q000097:blood*; D018276:Carcinoma, Medullary / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013964:Thyroid Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D002116:Calcitonin