BACKGROUND AND AIMS: Patients with sporadic medullary thyroid carcinoma (MTC) have a variable clinical course. Our aim was to analyse the reduction of tumour markers after thyroidectomy with meticulous dissection and relate it to clinical outcome. MATERIALS AND METHODS: Twenty consecutive patients with palpable sporadic MTC underwent thyroidectomy with central and uni- or bilateral modified radical neck dissection; three were subjected to mediastinal dissection. Basal (b-) and stimulated (s-) calcitonin (CT) and carcinoembryonic antigen (CEA)-levels were measured before and 6-8 weeks after primary surgery, and the reduction of these tumour markers was determined. RESULTS: Median CT (b- and s-) were markedly reduced after surgery (98.5% and 99.1%, respectively), and CEA decreased 11 times. CT (b-) fell >99% in seven patients after surgery; in these and four additional patients, CT (s-) showed a similar reduction. During follow-up (median 52.5 months), two patients (stages IV B and C) died of MTC; they had <95% reduction of CT. Four patients (stage IV A) are alive with verified metastases. Eight patients (one stage III, seven stage IV A) are alive with hypercalcitoninemia. Five stages I-III patients and one stage IV A patient are disease-free. CONCLUSIONS: Thyroidectomy and meticulous dissection caused a pronounced reduction of tumour markers. A postoperative reduction of CT (s-) >or=97% seems to be associated with less aggressive clinical course, while CEA had lower predictive value.
BACKGROUND AND AIMS: Patients with sporadic medullary thyroid carcinoma (MTC) have a variable clinical course. Our aim was to analyse the reduction of tumour markers after thyroidectomy with meticulous dissection and relate it to clinical outcome. MATERIALS AND METHODS: Twenty consecutive patients with palpable sporadic MTC underwent thyroidectomy with central and uni- or bilateral modified radical neck dissection; three were subjected to mediastinal dissection. Basal (b-) and stimulated (s-) calcitonin (CT) and carcinoembryonic antigen (CEA)-levels were measured before and 6-8 weeks after primary surgery, and the reduction of these tumour markers was determined. RESULTS: Median CT (b- and s-) were markedly reduced after surgery (98.5% and 99.1%, respectively), and CEA decreased 11 times. CT (b-) fell >99% in seven patients after surgery; in these and four additional patients, CT (s-) showed a similar reduction. During follow-up (median 52.5 months), two patients (stages IV B and C) died of MTC; they had <95% reduction of CT. Four patients (stage IV A) are alive with verified metastases. Eight patients (one stage III, seven stage IV A) are alive with hypercalcitoninemia. Five stages I-III patients and one stage IV A patient are disease-free. CONCLUSIONS: Thyroidectomy and meticulous dissection caused a pronounced reduction of tumour markers. A postoperative reduction of CT (s-) >or=97% seems to be associated with less aggressive clinical course, while CEA had lower predictive value.
Authors: H Gharib; W M McConahey; R D Tiegs; E J Bergstralh; J R Goellner; C S Grant; J A van Heerden; G W Sizemore; I D Hay Journal: Mayo Clin Proc Date: 1992-10 Impact factor: 7.616
Authors: J B Fleming; J E Lee; M Bouvet; P N Schultz; S I Sherman; R V Sellin; K E Friend; M A Burgess; G J Cote; R F Gagel; D B Evans Journal: Ann Surg Date: 1999-11 Impact factor: 12.969
Authors: S A Hundahl; B Cady; M P Cunningham; E Mazzaferri; R F McKee; J Rosai; J P Shah; A M Fremgen; A K Stewart; S Hölzer Journal: Cancer Date: 2000-07-01 Impact factor: 6.860
Authors: M R Pelizzo; I M Boschin; P Bernante; A Toniato; A Piotto; C Pagetta; O Nibale; L Rampin; P C Muzzio; D Rubello Journal: Eur J Surg Oncol Date: 2006-11-27 Impact factor: 4.424