title: Consensus on management of advanced medullary thyroid carcinoma on behalf of the Working Group of Thyroid Cancer of the Spanish Society of Endocrinology (SEEN) and the Spanish Task Force Group for Orphan and Infrequent Tumors (GETHI).
abstract: BACKGROUND
  Of all thyroid cancers, <5 % are medullary (MTC). It is a well-characterized neuroendocrine tumor arising from calcitonin-secreting C cells, and RET gene plays a central role on its pathogeny.
  
  
  METHODS
  The electronic search was conducted using MEDLINE (PubMed), EMBASE and Cochrane Central Register of Controlled Trials. Quality assessments of selected current articles, guidelines and reviews of MTC were performed.
  
  
  RESULTS
  This consensus updates and summarizes biology, treatment and prognostic considerations of MTC.
  
  
  CONCLUSIONS
  Multidisciplinary teams and specialized centers are recommended for the management of MTC patients. In the metastatic setting, those patients with large volume of disease are candidates to start systemic treatment mainly if they are symptomatic and the tumor has progressed in the last 12-14 months. Wait and see strategy should be offered to patients with: disseminated disease with only high levels of calcitonin and no macroscopic structural disease, low burden and absence of progression.
authors.affiliation: Servicio de Oncología Médica, Hospital Ramón y Cajal, Carretera de Colmenar km 9,1, 28034, Madrid, Spain. egrande@oncologiahrc.com.
authors.forename: E
authors.initials: E
authors.lastname: Grande
authors.affiliation: Endocrinology and Nutrition Service, Hospital Universitario de Cruces, Vizcaya, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Santamaría Sandi
authors.affiliation: Medical Oncology Service, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Capdevila
authors.affiliation: Endocrinology and Nutrition Service, Hospital Universitario Virgen del Rocio, Seville, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Navarro González
authors.affiliation: Endocrinology and Nutrition Service, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Zafón Llopis
authors.affiliation: Medical Oncology Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: T
authors.initials: T
authors.lastname: Ramón Y Cajal Asensio
authors.affiliation: CIBERDEM, Endocrinology and Nutrition Service, Hospital Universitario de Bellvitge, Barcelona, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Gómez Sáez
authors.affiliation: Medical Oncology Service, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Jiménez-Fonseca
authors.affiliation: Endocrinology and Nutrition Service, Hospital Universitario de Móstoles, Madrid, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Riesco-Eizaguirre
authors.affiliation: Endocrinology and Nutrition Service, Clínica Universidad de Navarra, Pamplona, Spain.
authors.forename: J C
authors.initials: JC
authors.lastname: Galofré
mesh_terms: D018278:Carcinoma, Neuroendocrine / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000628:therapy*
keywords: Cabozantinib; Calcitonin; Carcinoembryonic antigen; Medullary thyroid carcinoma; Review; Thyroid cancer; Vandetanib