Calcitonin kinetics in the early postoperative period of medullary thyroid carcinoma

Brauckhoff, Michael; Gimm, Oliver; Brauckhoff, Katrin; Ukkat, Jörg; Thomusch, Oliver; Dralle, Henning

doi:10.1007/s004230100252

Cited by 29 publications

(17 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In order to use it, one should not delay the serial Ct and CEA measurements after surgery. According to Brauckhoff et al [7], reliable Ct assessments are obtained one month after thyroidectomy in almost every patient. Notably, in high-risk patients, with short DT, we can obtain reliable DT estimation much more earlier - after one or two DTs, so when the post-surgery Ct or CEA concentration is elevated, subsequent measurements should be taken in relatively short intervals, e.g.…”

Section: Discussionmentioning

confidence: 99%

The prognostic value of tumor markers doubling time in medullary thyroid carcinoma - preliminary report

et al. 2010

View full text Add to dashboard Cite

IntroductionCalcitonin (Ct) and carcinoembrional antigen (CEA) are widely used as tumor markers for the post-operative follow-up of patients with medullary thyroid carcinoma (MTC).In patients with elevated serum Ct and CEA their dynamics can be described by calculating the doubling time (DT) - the time, they need to double the serum concentration. Previous reports concluded that the Ct and CEA DT have prognostic value in MTC patients.Patients and methodsWe retrospectively analyzed data of 70 MTC patients with elevated serum Ct or CEA. In total, doubling times were calculated and the DT of the less favorable marker was used to stratify the patients into the low- and high-risk group with the cut-off value of 2 years. The survival analysis was performed using Cox proportional hazard method.ResultsThe doubling time < = 2 years of the less-favorable marker had significant prognostic impact for recurrence-free survival, HR = 2.61 (1.43-4.71) and overall survival, HR = 8.99 (3.51-23.04).ConclusionsThe calcitonin and carcinembrional antigen doubling times of less than two years are negative prognostic factors for MTC recurrence-free and total survival in patients with persistent or recurrent disease. They may be used as predictive factors for more intensive search of disease localization in asymptomatic hypercalcitoninemia and for therapy choice in symptomatic disease.

show abstract

Section: Discussionmentioning

confidence: 99%

The prognostic value of tumor markers doubling time in medullary thyroid carcinoma - preliminary report

et al. 2010

View full text Add to dashboard Cite

show abstract

“…However, cases of detectable and even elevated postoperative CT levels after total tumor excision without apparent recurrence or metastases are documented abundantly (van Heerden et al 1990). Brauckhoff et al (2001) studied a 14-patient group and found pathological basal CT levels in only one of them 12 months later (Brauckhoff). They supposed that the delayed postoperative CT normalization and possibly CT stimulation, observed in some patients, could be an indicator for pre-or perioperative dissemination of tumor cells.…”

Section: Discussionmentioning

confidence: 99%

Postoperative calcitonin study in medullary thyroid carcinoma.

Ismailov

Piulatova²

2004

Endocr Relat Cancer

View full text Add to dashboard Cite

Calcitonin (CT) is a sensitive marker for medullary thyroid carcinoma. Normalization of early postoperative CT level is a favorable prognostic factor. The aim of this study was to establish the prognostic value of CT-level kinetics by preoperative tumor stage and postoperative elimination rate. Blood serum from 22 medullary thyroid carcinoma (MTC) patients without remote metastases was assayed. A commercial RIA DSL-1200 test was used to assay CT levels. Basal CT 42 pg/ml and stimulated CT 120 pg/ml were considered normal. The patients were divided into three groups according to the intensity of the postoperative CT level reduction in blood serum. Group 1 comprised patients who showed basal CT normalization within the first 2-3 days after surgery. Group 2 included those patients with slow (from 2 to 4 weeks) CT-level normalization. Group 3 included patients with CT levels that reduced within 14 days, but subsequently increased. Preoperative basal CT varies from 216 to 1654 pg/ml and depends on tumor-node-metastasis (TNM) stage. In seven patients, no basal CT decrease to normal values was observed; in five of these patients, disease recurrence was detected 2-6 months after surgery. In the group with slowly decreasing CT levels, no strong correlation between preoperative CT level and the postoperative time to normalization of basal and peak CT could be established; this may be due to the small number of patients. Our study showed that preoperative CT level depended on the disease stage. Postoperative CT elimination rate is independent of preoperative CT level. Postoperative increase in the basal or stimulated CT level is an unfavorable prognostic factor, implying disease recurrence.

show abstract

“… Lifelong follow‐up is recommended (4, D) . Key recommendation Postoperatively, calcitonin should be measured no earlier than 15 days after thyroidectomy and may take more than 2 months to fall to the lowest level . Response to primary surgery can be assessed clinically and by the measurement of serum calcitonin and carcinembryonic antigen (CEA) usually 6 months after surgery (4, D).…”

Section: Chapter 17mentioning

confidence: 99%