Biochemical results of reoperations for medullary thyroid carcinoma.
BACKGROUND
The calcitonin is a sensitive marker for the presence of medullary thyroid carcinoma, therefore, invaluable in the follow-up of patients who have been treated. Biological cure of the medullary thyroid cancer refers to a basal plasma calcitonin of less than 10 ng/l without elevation after stimulation tests.


METHODS
Biochemical results of reoperations for medullary thyroid carcinoma were reviewed from a series of 35 patients who underwent 47 reinterventions.


RESULTS
The indications for reoperation were: hypercalcitoninemia with clinical evidence of the disease (32 cases); hypercalcitoninemia after an inadequate primary surgery (6 cases); persistent hypercalcitoninemia with biochemical evidence of the disease (2 cases); liver metastases (1 case); and palliative surgery for relieving symptoms (1 case). Only three patients of the series had biochemical cure after reoperation (patients with an inadequate primary surgery).


CONCLUSIONS
This study is consistent with the bibliographic reviews supporting that the cervical reoperation, eventually mediastinal, for residual hypercalcitoninemia after primary surgical treatment is indicated when the initial intervention did not follow the French Calcitonin Tumour Study Group (GETC) recommendations or when a specific lesion is evidenced by imaging studies without systemic dissemination.
Fernandez Vila
Juan Manuel
JM
Service of General Surgery and Head and Neck Surgery, Hospital Alemán de Buenos Aires, Argentina. fernandezvila@hotmail.com
Peix
Jean L
JL
Mandry
Alexandra C
AC
Mezzadri
Norberto A
NA
Lifante
Jean C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002116:Calcitonin / Q000097:blood*; D018276:Carcinoma, Medullary / Q000097:blood* / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood; D012086:Reoperation; D013964:Thyroid Neoplasms / Q000097:blood* / Q000601:surgery*
D002116:Calcitonin