Repeat mediastinal lymph-node dissection for palliation in advanced medullary thyroid carcinoma

1999 ◽  
Vol 384 (3) ◽  
pp. 271-276 ◽  
Author(s):  
A. Machens ◽  
Oliver Gimm ◽  
Jörg Ukkat ◽  
Thomas Sutter ◽  
Henning Dralle
Keyword(s):  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Lymph Node Dissection ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Node Dissection ◽  
Node Dissection ◽  
Medullary Thyroid

scholarly journals EP1.15-14 Mediastinal Lymph Node Dissection Through Median Sternotomy in Thyroid Carcinoma

2019 ◽  
Vol 14 (10) ◽  
pp. S1057-S1058
Author(s):  
Y. Yamada ◽  
J. Maeda ◽  
T. Hoshino ◽  
T. Yokota ◽  
T. Uruno ◽  
...  
Keyword(s):  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Lymph Node Dissection ◽  
Mediastinal Lymph Node ◽  
Median Sternotomy ◽  
Mediastinal Lymph Node Dissection ◽  
Node Dissection

Medullary thyroid carcinoma in children: current state of the art and future perspectives

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Andreas Kiriakopoulos ◽  
Anastasia Dimopoulou ◽  
Constantinos Nastos ◽  
Dimitra Dimopoulou ◽  
Konstantina Dimopoulou ◽  
...  
Keyword(s):  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Lymph Node Dissection ◽  
Locally Advanced ◽  
Biological Behavior ◽  
Prophylactic Surgery ◽  
Node Dissection ◽  
Serum Calcitonin ◽  
Medullary Thyroid

Abstract Medullary thyroid carcinoma (MTC) is a distinct type of malignant thyroid tumor in cell origin, biological behavior, and natural history. It accounts for 1.6% of all thyroid cancers and presents either sporadically or as a hereditary disease, the latter occurring as a part of multiple endocrine neoplasia (MEN) 2A and MEN2B syndromes or as a familial MTC disease with no other manifestations. The gene responsible for the hereditary form is the rearranged during transfection (RET) gene, a proto-oncogene located to human chromosome 10. Most pediatric MTC cases have been discovered after genetic testing investigations, leading to the concept of prophylactic surgery in presymptomatic patients. Therefore, the genetic status of the child, along with serum calcitonin levels and ultrasonographic findings, determine the appropriate age for prophylactic surgical intervention. Nevertheless, a diagnosis at an early stage of MTC warrants total thyroidectomy and central lymph node dissection with the addition of lateral/contralateral lymph node dissection depending on the tumor size, ultrasonographic evidence of neck disease, or calcitonin levels. Conversely, locally advanced/unresectable or metastatic MTC is primarily treated with multikinase inhibitors, while more specific RET inhibitors are being tested in clinical trials with promising results.

scholarly journals Complications after medullary thyroid carcinoma surgery: multicentre study of the SQRTPA and EUROCRINE® databases

2021 ◽  
Vol 108 (6) ◽  
pp. 691-701
Author(s):  
D -J van Beek ◽  
M Almquist ◽  
A O Bergenfelz ◽  
T J Musholt ◽  
E Nordenström ◽  
...  
Keyword(s):  
Risk Factors ◽  
Lymph Node ◽  
Thyroid Carcinoma ◽  
Medullary Thyroid Carcinoma ◽  
Lymph Node Dissection ◽  
Node Dissection ◽  
Lateral Lymph Node ◽  
Medullary Thyroid ◽  
Curative Therapy ◽  
Central Lymph Node Dissection

Abstract Background Surgery is the curative therapy for patients with medullary thyroid carcinoma (MTC). In determining the extent of surgery, the risk of complications should be considered. The aim of this study was to assess procedure-specific outcomes and risk factors for complications after surgery for MTC. Methods Patients who underwent thyroid surgery for MTC were identified in two European prospective quality databases. Hypoparathyroidism was defined by treatment with calcium/active vitamin D. Recurrent laryngeal nerve (RLN) palsy was diagnosed on laryngoscopy. Complications were considered at least transient if present at last follow-up. Risk factors for at-least transient hypoparathyroidism and RLN palsy were identified by logistic regression analysis. Results A total of 650 patients underwent surgery in 69 centres at a median age of 56 years. Hypoparathyroidism, RLN palsy and bleeding requiring reoperation occurred in 170 (26·2 per cent), 62 (13·7 per cent) and 17 (2·6 per cent) respectively. Factors associated with hypoparathyroidism were central lymph node dissection (CLND) (odds ratio (OR) 2·20, 95 per cent c.i. 1·04 to 4·67), CLND plus unilateral lateral lymph node dissection (LLND) (OR 2·78, 1·20 to 6·43), CLND plus bilateral LLND (OR 2·83, 1·13 to 7·05) and four or more parathyroid glands observed (OR 4·18, 1·46 to 12·00). RLN palsy was associated with CLND plus LLND (OR 4·04, 1·12 to 14·58) and T4 tumours (OR 12·16, 4·46 to 33·18). After compartment-oriented lymph node dissection, N0 status was achieved in 248 of 537 patients (46·2 per cent). Conclusion Complications after surgery for MTC are procedure-specific and may relate to the unavoidable consequences of radical dissection needed in some patients.

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