Andreas Machens1, Kerstin Lorenz2, Henning Dralle2,3. 1. Department of General, Visceral and Vascular Surgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06097, Halle (Saale), Germany. AndreasMachens@aol.com. 2. Department of General, Visceral and Vascular Surgery, Medical Faculty, Martin Luther University Halle-Wittenberg, Ernst-Grube-Strasse 40, D-06097, Halle (Saale), Germany. 3. Department of General, Visceral and Transplantation Surgery, Section of Endocrine Surgery, University of Duisburg-Essen, Essen, Germany.
Abstract
PURPOSE: To delineate risk factors for, and examine temporal patterns of, histology-proven recurrent medullary thyroid cancer (MTC) after compartment-oriented surgery. METHODS: Multivariate Cox regression on overall, node, and soft tissue infiltrate recurrence per previously dissected neck compartment. RESULTS: Mean follow-up for the 203 (and 158) patients with central (and ipsilateral lateral) neck dissection was 56.1 months. On multivariate Cox regression, tumor size > 20 mm predicted overall and node recurrence in the central neck, whereas extranodal growth predicted overall and node recurrence in the ipsilateral lateral neck. Extrathyroidal extension alone predicted soft tissue infiltrate recurrence in the central neck, and extranodal growth alone soft tissue infiltrate recurrence in the ipsilateral lateral neck. When analyses were restricted to patients not biochemically cured after initial surgery, only extranodal growth predicted overall and node recurrence in the dissected neck compartments. CONCLUSIONS: Patients not biochemically cured, specifically those with extranodal growth at the initial operation, carry greater risks of node recurrence.
PURPOSE: To delineate risk factors for, and examine temporal patterns of, histology-proven recurrent medullary thyroid cancer (MTC) after compartment-oriented surgery. METHODS: Multivariate Cox regression on overall, node, and soft tissue infiltrate recurrence per previously dissected neck compartment. RESULTS: Mean follow-up for the 203 (and 158) patients with central (and ipsilateral lateral) neck dissection was 56.1 months. On multivariate Cox regression, tumor size > 20 mm predicted overall and node recurrence in the central neck, whereas extranodal growth predicted overall and node recurrence in the ipsilateral lateral neck. Extrathyroidal extension alone predicted soft tissue infiltrate recurrence in the central neck, and extranodal growth alone soft tissue infiltrate recurrence in the ipsilateral lateral neck. When analyses were restricted to patients not biochemically cured after initial surgery, only extranodal growth predicted overall and node recurrence in the dissected neck compartments. CONCLUSIONS:Patients not biochemically cured, specifically those with extranodal growth at the initial operation, carry greater risks of node recurrence.
Authors: Markus Luster; Wolfram Karges; Katrin Zeich; Sandra Pauls; Frederik A Verburg; Henning Dralle; Gerhard Glatting; Andreas K Buck; Christoph Solbach; Bernd Neumaier; Sven N Reske; Felix M Mottaghy Journal: Thyroid Date: 2010-05 Impact factor: 6.568
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Authors: Johannes A A Meijer; Saskia le Cessie; Wilbert B van den Hout; Job Kievit; Johannes W Schoones; Johannes A Romijn; Johannes W A Smit Journal: Clin Endocrinol (Oxf) Date: 2009-06-26 Impact factor: 3.478
Authors: Henning Dralle; Thomas J Musholt; Jochen Schabram; Thomas Steinmüller; Andreja Frilling; Dietmar Simon; Peter E Goretzki; Bruno Niederle; Christian Scheuba; Thomas Clerici; Michael Hermann; Jochen Kußmann; Kerstin Lorenz; Christoph Nies; Peter Schabram; Arnold Trupka; Andreas Zielke; Wolfram Karges; Markus Luster; Kurt W Schmid; Dirk Vordermark; Hans-Joachim Schmoll; Reinhard Mühlenberg; Otmar Schober; Harald Rimmele; Andreas Machens Journal: Langenbecks Arch Surg Date: 2013-03-03 Impact factor: 3.445
Authors: Hans H G Verbeek; John T M Plukker; Klaas Pieter Koopmans; Jan Willem B de Groot; Robert M W Hofstra; Anneke C Muller Kobold; Anouk N A van der Horst-Schrivers; Adrienne H Brouwers; Thera P Links Journal: J Nucl Med Date: 2012-10-18 Impact factor: 10.057
Authors: R Peto; M C Pike; P Armitage; N E Breslow; D R Cox; S V Howard; N Mantel; K McPherson; J Peto; P G Smith Journal: Br J Cancer Date: 1977-01 Impact factor: 7.640