Andrea Polistena1, Alessandro Sanguinetti2, Roberta Lucchini3, Sergio Galasse4, Massimo Monacelli5, Stefano Avenia6, Andrea Boccolini7, Louis Banka Johnson8, Nicola Avenia9. 1. University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy. Electronic address: apolis74@yahoo.it. 2. University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy. Electronic address: alessandrosanguinetti@gmail.com. 3. University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy. Electronic address: robertalucchini@alice.it. 4. University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy. Electronic address: galassergio@libero.it. 5. University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy. Electronic address: massimo.monacelli@gmail.com. 6. University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy. Electronic address: stefano_avenia@libero.it. 7. University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy. Electronic address: a.boccolini86@gmail.com. 8. University of Lund, Surgical Department, Skåne University Hospital, Malmö, Sweden. Electronic address: louis.johnson@med.lu.se. 9. University of Perugia, Medical School, Endocrine Surgery Unit, S. Maria University Hospital, Terni, Italy. Electronic address: nicolaavenia@libero.it.
Abstract
BACKGROUND: Medullary thyroid carcinoma is an aggressive tumor and presents with significant morbidity and mortality and a high rate of lymph node metastases. The combination of total thyroidectomy and cervical lymphadenectomy is the essential treatment for those patients presenting with cervical lymph node metastases. MATERIALS AND METHODS: A retrospective analysis of 117 patients operated for medullary thyroid carcinoma over a period of 15 years at a single institution. Surgical complications and calcitonin levels were noted. RESULTS: Nodal metastases were detected in the central compartment in 72.6% patients. Positive lymph nodes were detected in the lateral compartment of 34 patients who had undergone ipsilateral dissection and in all 10 patients of those with bilateral surgery. We found 3 cases of unilateral transient recurrent laryngeal nerve palsy, 15 cases of temporary hypoparathyroidism, a permanent accessory nerve lesion and a case of chylous fistula. Normalization of post-operative calcitonin was found in 82.6% and of patients who underwent total thyroidectomy and central neck dissection alone compared to 35.4% in those with ipsilateral and bilateral neck dissection. CONCLUSIONS: Total thyroidectomy and cervical lymphadenectomy planned on the ultrasound preoperative study and on the calcitonin level represent the standard of treatment for medullary thyroid carcinoma.
BACKGROUND: Medullary thyroid carcinoma is an aggressive tumor and presents with significant morbidity and mortality and a high rate of lymph node metastases. The combination of total thyroidectomy and cervical lymphadenectomy is the essential treatment for those patients presenting with cervical lymph node metastases. MATERIALS AND METHODS: A retrospective analysis of 117 patients operated for medullary thyroid carcinoma over a period of 15 years at a single institution. Surgical complications and calcitonin levels were noted. RESULTS: Nodal metastases were detected in the central compartment in 72.6% patients. Positive lymph nodes were detected in the lateral compartment of 34 patients who had undergone ipsilateral dissection and in all 10 patients of those with bilateral surgery. We found 3 cases of unilateral transient recurrent laryngeal nerve palsy, 15 cases of temporary hypoparathyroidism, a permanent accessory nerve lesion and a case of chylous fistula. Normalization of post-operative calcitonin was found in 82.6% and of patients who underwent total thyroidectomy and central neck dissection alone compared to 35.4% in those with ipsilateral and bilateral neck dissection. CONCLUSIONS: Total thyroidectomy and cervical lymphadenectomy planned on the ultrasound preoperative study and on the calcitonin level represent the standard of treatment for medullary thyroid carcinoma.
Authors: Else Marie Opsahl; Lars Andreas Akslen; Ellen Schlichting; Turid Aas; Katrin Brauckhoff; Anne Irene Hagen; Alf Frimann Rosenlund; Eva Sigstad; Krystyna K Grøholt; Lars H Jørgensen; Trine Bjøro Journal: Eur Thyroid J Date: 2019-04-29
Authors: Lindsey E Moses; Jamie R Oliver; Janine M Rotsides; Qianhui Shao; Kepal N Patel; Luc G T Morris; Babak Givi Journal: Head Neck Date: 2020-10-27 Impact factor: 3.147