Locoregional control in patients with palpable medullary thyroid cancer: results of standardized compartment-oriented surgery.
BACKGROUND
Extent of neck dissection is controversial in patients with palpable medullary thyroid cancer (MTC).


METHODS
We evaluated 64 MTC patients (19 hereditary, 45 sporadic) with palpable thyroid nodules (group 1, n = 35) or palpable lymph node metastases (group 2, n = 29). Standard surgery included total thyroidectomy, central compartment dissection, and additional neck dissection on indication.


RESULTS
In group 1, 40% of the patients were cured. Thirty-one percent of all patients had central, 23% ipsilateral, 14% contralateral, and 14% mediastinal, metastases. Fifty-one percent developed locoregional recurrence. Locoregional recurrence (p = .043) and reoperations (p = .020) were noted more often after a less than standard initial procedure. In group 2, no patients were cured. All had central, 93% ipsilateral, 45% contralateral, and 52% mediastinal metastases. Thirty-eight percent developed locoregional recurrence.


CONCLUSIONS
Locoregional recurrence frequently occurs in palpable MTC, and tumor control may be improved by standard central, bilateral, and upper mediastinal neck dissection.
de Groot
Jan Willem B
JW
Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, The Netherlands.
Links
Thera P
TP
Sluiter
Willem J
WJ
Wolffenbuttel
Bruce H R
BH
Wiggers
Theo
T
Plukker
John Th M
JT
D000293:Adolescent; D000328:Adult; D000368:Aged; D002116:Calcitonin / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D002648:Child; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy
D002272:Carcinoembryonic Antigen; D002116:Calcitonin