title: Role of preoperative basal calcitonin levels in the timing of prophylactic thyroidectomy in patients with germline RET mutations.
abstract: BACKGROUND
  The American Thyroid Association (ATA) published recommendations for the timing of prophylactic surgery for medullary thyroid carcinoma based on the specific mutation, patient age, family history, and serum calcitonin levels. The aim of this study was to assess the role of preoperative basal calcitonin (prebCt) levels in predicting the presence of medullary carcinoma of the thyroid in patients with RET mutations.
  
  
  METHODS
  We conducted a retrospective study in two endocrine surgery departments. Between 1986 and 2012, a total of 32 patients with RET mutations underwent prophylactic thyroidectomy. The patients were stratified into four ATA risk levels: A, B, C, and D.
  
  
  RESULTS
  All of the patients were biologically cured. Microcarcinoma was observed in the final pathology report for four of the 20 patients with normal prebCt (25 %) and for nine of the 12 patients with elevated prebCt (75 %). In the level A group, four patients with normal prebCt and one patient with elevated prebCt presented with microcarcinoma. In the level C group, one patient with normal prebCt and six of the seven patients with elevated prebCt (86 %) presented with microcarcinoma.
  
  
  CONCLUSIONS
  PrebCt can predict the presence of microcarcinoma according to surgical pathological analysis. Patients with microcarcinoma can be biochemically and clinically cured using prophylactic thyroidectomy.
authors.affiliation: Department of General, Digestive and Endocrine Surgery, Centre Hospitalier Lyon Sud, Université Claude Bernard Lyon 1, Rue du grand Revoyet, 69495, Pierre Bénite, France, jean-christophe.lifante@chu-lyon.fr.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Lifante
authors.forename: Claire
authors.initials: C
authors.lastname: Blanchard
authors.forename: Eric
authors.initials: E
authors.lastname: Mirallié
authors.forename: Albert
authors.initials: A
authors.lastname: David
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Peix
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000235:genetics*; D002116:Calcitonin / Q000097:blood*; D018276:Carcinoma, Medullary / Q000097:blood / Q000175:diagnosis / Q000235:genetics / Q000517:prevention & control*; D018278:Carcinoma, Neuroendocrine; D002648:Child; D002675:Child, Preschool; D005260:Female; D018095:Germ-Line Mutation; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D051096:Proto-Oncogene Proteins c-ret / Q000235:genetics*; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000097:blood / Q000175:diagnosis / Q000235:genetics / Q000517:prevention & control*; D013965:Thyroidectomy; D013997:Time Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D002116:Calcitonin; D051096:Proto-Oncogene Proteins c-ret; C099282:RET protein, human