Surgical management of medullary thyroid cancer: which guidelines should we follow?

Bowen, Alex; Mani, Navin; Penney, Susannah; Loughran, Sean; Yap, Beng K

doi:10.1017/s0022215115000237

Cited by 5 publications

(6 citation statements)

References 23 publications

(88 reference statements)

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“…Bei medullären Schilddrüsenkarzinomen ist bei entsprechender Ausdehnung die komplette Thyroidektomie mit ausgedehnter Neck dissection die einzige Option auf Kuration [25], die sich dann in einem Calcitoninwert von nahe null als Ausdruck der "biochemischen Heilung" widerspiegelt [6].…”

Section: Materials Und Methodenunclassified

Die Behandlung von Schilddrüsenmalignomen aus HNO-ärztlicher Sicht

Issing¹,

Köhler²,

Tebben³

et al. 2021

Laryngorhinootologie

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Zusammenfassung Einleitung Die Zahl der Schilddrüsenmalignome zeigt eine deutliche Zunahme. Da die Schilddrüse an der HNO-Klinik Bad Hersfeld im Fokus steht, war dies für uns Anlass, unsere Behandlungsresultate zu untersuchen und Erfahrungen darzustellen. Material und Methoden Es handelt sich um eine Untersuchung beginnend im Jahre 2014 bis zum Juli 2020. Es wurden alle Patienten mit Schilddrüsenmalignomen erfasst und wichtige demografische und medizinische Parameter wie Alter, Geschlecht, Histologie, Calcium, OP-Dauer, Rekurrensparese etc. registriert. Ergebnisse Es wurden insgesamt 63 Patienten mit malignen Schilddrüsenerkrankungen eingeschlossen. Davon waren 42 weiblichen und 21 männlichen Geschlechts. Die Altersspanne reichte von 11 bis zu 95 Jahren. Patienten mit differenzierten Schilddrüsenkarzinomen waren im Schnitt jünger als diejenigen mit anaplastischen Malignomen. Histologisch dominierten die papillären Schilddrüsenkarzinome mit 65 % (n = 41) gegenüber anderen Varianten wie dem follikulären (n = 6), medullären (n = 5) und entdifferenzierten Karzinom (n = 6). Alle Patienten wurden einer operativen Behandlung unterzogen; postoperativ erhielten die Betroffenen mit fortgeschrittenen, differenzierten Karzinomen eine Radiojodtherapie. Von den Patienten mit einem entdifferenzierten Karzinom sind alle ihrem Leiden erlegen, während nach unserer Kenntnis nur eine Betroffene mit einem differenzierten Malignom tumorbedingt verstorben ist. Schlussfolgerung In die Behandlung von malignen Schilddrüsenerkrankungen ist der HNO-Arzt eingebunden. Wie bei den benignen Erkrankungen der endokrinen Halsorgane ist eine interdisziplinäre Zusammenarbeit entscheidend.

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Section: Materials Und Methodenunclassified

Die Behandlung von Schilddrüsenmalignomen aus HNO-ärztlicher Sicht

Issing¹,

Köhler²,

Tebben³

et al. 2021

Laryngorhinootologie

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“…Patients with diagnosed MTC should be subjected to total thyroidectomy since all cases with hereditary MTC, as well as 30% of those with sporadic MTC have multifocal disease at the time of the diagnosis [ 37 ]. In cases of localized MTC, where there is no evidence of cervical lymph node or distant metastases, total thyroidectomy and central (levels VI and VII) dissection is the procedure of choice.…”

Section: ⧉ Surgical Treatmentmentioning

confidence: 99%

“…In cases of localized MTC, where there is no evidence of cervical lymph node or distant metastases, total thyroidectomy and central (levels VI and VII) dissection is the procedure of choice. Central lymph node dissection might be omitted safely only in patients with T1a disease [ 37 ]. The role of lateral lymph node dissection still remains controversial.…”

Section: ⧉ Surgical Treatmentmentioning

confidence: 99%

“…Some authors advocate that lateral lymph node dissection should only be reserved for cases of positive for lateral lymph node metastatic disease imaging or histological findings. Others propose the evaluation of preoperative Ct levels and tumor size as criteria for deciding whether it is necessary or not [ 37 , 38 ]. In cases of a tumor over 3 mm and Ct levels ranging between 20 pg/mL and 200 pg/mL, ipsilateral lateral lymph node dissection is advised as it increases the percentage of biochemical cure.…”

Section: ⧉ Surgical Treatmentmentioning

confidence: 99%

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Medullary thyroid cancer: molecular factors, management and treatment

Pavlidis

Sapalidis²,

Chatzinikolaou³

et al. 2021

Rom J Morphol Embryol

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Medullary thyroid cancer (MTC) is an infrequent neuroendocrine tumor, which amounts to 3–5% of all thyroid malignancies. Approximately 75–80% of MTCs are sporadic neoplasms. The rest of 20–25% are familial cases that belong to multiple endocrine neoplasia (MEN) syndromes, specifically MEN2 and MEN3. These cases of familial MTC are attributed to an activating germline mutation of a tyrosine kinase receptor gene, the rearranged during transfection ( RET ) proto-oncogene, located on chromosome 10q11.21. These mutations are also found in some cases of sporadic MTC. This review sets forth in summary the accepted guidelines and approaches regarding diagnosis, management, and treatment of MTC. Surgical resection is the standard care, and an early, prophylactic intervention is performed in genetic cases. Further investigation and understanding of the molecular pathways involved in the growth and advancement of MTC is required in order to provide efficient therapy in cases of progressive disease.

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“…Ipsilateral cervical node and contralateral node metastases are also common in advanced stage cancer. Lateral lymph node dissection may provide a better chance of cure in stage IVa patients with metastasis to cervical, retropharyngeal or superior mediastinal lymph nodes [50], but is associated with a higher morbidity. Spinal accessory nerve damage and lymphatic leakage are two main complications that can lead to shoulder dysfunction.…”

Section: • Surgerymentioning

confidence: 99%

Recent Advances in the Management of Endocrine Malignancies Associated with Hereditary Hyperparathyroidism Syndromes

Li¹,

Simonds

2017

Int. J. Endo. Oncol.

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Hereditary hyperparathyroidism syndromes, such as multiple endocrine neoplasm type 1, type 2A and the hyperparathyroidism-jaw tumor syndrome, are associated with an increased incidence of malignancies involving the neuroendocrine tissue of the pancreas and thymus, parathyroid and thyroid glands. The natural history of these endocrine tumors can differ from nonhereditary malignancies. The surgical approach, the only potentially curative treatment option for these endocrine malignancies, has evolved considerably in recent years. Newer targeted therapies, such as small molecule kinase inhibitors, somatostatin analogs and peptide receptor radionuclide therapy, are being developed. We provide here a comprehensive review of the current standards of treatment and emerging novel therapies for the endocrine malignancies commonly associated with hereditary hyperparathyroidism syndromes.

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Surgical management of medullary thyroid cancer: which guidelines should we follow?

Cited by 5 publications

References 23 publications

Die Behandlung von Schilddrüsenmalignomen aus HNO-ärztlicher Sicht

Die Behandlung von Schilddrüsenmalignomen aus HNO-ärztlicher Sicht

Medullary thyroid cancer: molecular factors, management and treatment

Recent Advances in the Management of Endocrine Malignancies Associated with Hereditary Hyperparathyroidism Syndromes

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