title: Surgical cure rates of sporadic medullary thyroid cancer in the era of calcitonin screening.
abstract: OBJECTIVE
  Time trends of the extent of disease at first diagnosis and biochemical cure remain ill-defined for sporadic medullary thyroid cancer (MTC). This investigation aimed to delineate time trends and biochemical cure rates for sporadic MTC.
  
  
  METHODS
  This was an observational study of consecutive patients operated on for sporadic MTC between 1995 and 2015.
  
  
  METHODS
  Time trends of clinical and histopathological variables indicative of the extent of disease and biochemical cure were calculated for 600 patients with sporadic MTC, 322 of whom had initial neck surgery and 278 of whom had neck reoperation at a tertiary surgical center in Germany.
  
  
  RESULTS
  From 1995-2000 to 2011-2015, significant declines (all P<0.001) were noted in the percentage of node-positive tumors (from 73 to 49%), mediastinal lymph node metastasis (from 21 to 6%) and distant metastasis (from 23 to 6%). These changes were paralleled by significant increases (all P<0.001) in mean patient age (from 49.1 to 57.3years) and the percentage of MTC ≤10mm (from 19 to 39%) and biochemical cure (from 28 to 62%). When only patients with primary tumors >10mm were considered, the decreasing percentage of mediastinal lymph node metastasis and distant metastasis, and rising mean patient age and biochemical cure rates remained statistically significant.
  
  
  CONCLUSIONS
  Significant reductions in the extent of the disease and improved biochemical cure rates pointed toward increasing therapeutic control of sporadic MTC. The independent contribution of routine calcitonin screening to these time-dependent changes warrants more research.
authors.affiliation: Department of GeneralVisceral and Vascular Surgery, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany AndreasMachens@aol.com.
authors.forename: Andreas
authors.initials: A
authors.lastname: Machens
authors.affiliation: Department of GeneralVisceral and Vascular Surgery, Medical Faculty, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany Department of GeneralVisceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Dralle
mesh_terms: D002116:Calcitonin / Q000097:blood*; D018276:Carcinoma, Medullary / Q000097:blood / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000097:blood / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome
chemical_list: D002116:Calcitonin