Author:

Keywords:

1103 Clinical Sciences, Otorhinolaryngology, 3202 Clinical sciences

Abstract:

Background: We reviewed our experience with medullary thyroid carcinoma (MTC), focusing on recurrence and survival, recommendations for extent of lymph node (LN) dissection and surgery for recurrent disease. Methods: Of 51 MTC patiënts treated between 1988 and 2008 at the University Hospitals Leuven, 38 previously untreated patients were analysed. Results: Overall and disease-specific (DSS) 5-year survival rates were 75 and 82%. Variables univariately associated with DSS were age, pN, stage vascular invasion, preoperative recurrent laryngeal nerve function and last calcitonin level. Recurrence appeared in 10 patients, 2 out of 6 (33%) undergoing a prophylactic central neck dissection (ND) based on peroperative palpatory suspicion proved pN+, and 2 out of 9 patients (22%) undergoing a prophylactic lateral ND were pN+. Five patients surgically treated for recurrence did not achieve long-term normalization of calcitonin, but remained alive with locoregional control. Conclusions: Survival and DSS are within the range reported in the literature. The results confirm that total thyroidectomy and central compartment dissection are the treatments of choice in the cN0 patients. In addition, for cN+ disease in the ipsilateral lateral compartment, an ipsilateral lateral ND is needed. In the clinically uninvolved contralateral lateral neck, peroperative inspecion should guide further ND. Locoregional control and prolonged survival are achieved in surgically treated locoregionally recurrent MTC.