Document Detail


Long-term outcome of reoperations for medullary thyroid carcinoma.
MedLine Citation:
PMID:  18188643     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Most patients with medullary thyroid carcinoma (MTC) have persistent disease after primary surgery, as evidenced by calcitonin elevation. Previous reports showed that reoperation on selected patients yields immediate calcitonin normalization in one-third of patients. Long-term follow-up data are needed to assess the outcome in such patients. This report aims to provide 8- to 10-year follow-up on reoperations for persistent or recurrent MTC.
METHODS: An Internal Review Board (IRB) approved database on patients treated for MTC has been prospectively maintained. This database was reviewed to report follow-up data on calcitonin levels and survival.
RESULTS: Between 1992 and 2006, 148 patients underwent reoperations for recurrent or persistent MTC (55 patients had 59 reoperations for palliation, and 93 patients had 105 reoperations for cure). Of the 93 patients operated on for cure (44 with hereditary MTC, 49 with the sporadic form), 8-10-year follow-up data were available on 56. Four patients died of disease (4.3% of 93). Two died of unrelated causes, and were excluded from calcitonin outcome analysis. Fourteen patients of 54 (26.0%) have unstimulated calcitonin levels of <10 pg/ml at 8-10 years. Eleven additional patients (20.4%) have levels<100 pg/ml. None of these 25 patients (46.4%) have radiologic recurrence.
CONCLUSIONS: Previous reports demonstrated the low morbidity of reoperation for MTC in experienced hands, and success was determined by lowering of calcitonin levels. Follow-up data demonstrate that at least one third of such patients have long-term eradication of their disease following reoperation, as evidenced by biochemical and imaging studies.
Authors:
Elizabeth Fialkowski; Mary DeBenedetti; Jeffrey Moley
Related Documents :
8287583 - Reversibility of thyroid dysfunction induced by recombinant alpha interferon in chronic...
21459943 - High prevalence of subclinical left ventricular dysfunction in patients with psoriatic ...
8957733 - Symptom-specific use of upper gastrointestinal endoscopy in human immunodeficiency viru...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  World journal of surgery     Volume:  32     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-18     Completed Date:  2008-10-10     Revised Date:  2013-10-01    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  754-65     Citation Subset:  IM    
Affiliation:
Department of General Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8109, Saint Louis, Missouri 63110, USA. fialkowskie@wudosis.wustl.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Calcitonin / blood
Carcinoma, Medullary / blood,  mortality,  surgery*
Disease-Free Survival
Female
Follow-Up Studies
Humans
Lymph Node Excision*
Male
Microdissection*
Neoplasm Recurrence, Local / blood,  mortality,  surgery*
Neoplasm, Residual
Reoperation
Thyroid Neoplasms / blood,  mortality,  surgery*
Thyroidectomy
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
P01CA53524/CA/NCI NIH HHS; P30 CA091842/CA/NCI NIH HHS; P30 CA091842/CA/NCI NIH HHS; T32CA09621/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
9007-12-9/Calcitonin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Risk-stratified management of well-differentiated thyroid cancers: a review of experience from a sin...
Next Document:  Construction of a novel Pichia pastoris cell-surface display system based on the cell wall protein P...