The Role of Calcitonin in Predicting the Extent of Surgery in Medullary Thyroid Carcinoma: A Nationwide Population-Based Study in Norway.
Calcitonin
Diagnostics
Medullary thyroid carcinoma
Outcome
Pathology
Prophylactic lymph node dissection
Surgery
Journal
European thyroid journal
ISSN: 2235-0640
Titre abrégé: Eur Thyroid J
Pays: England
ID NLM: 101604579
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
16
10
2018
revised:
18
02
2019
entrez:
2
7
2019
pubmed:
2
7
2019
medline:
2
7
2019
Statut:
ppublish
Résumé
Preoperative predictors for the need of prophylactic lymph node dissection in the lateral neck have been studied in patients with medullary thyroid carcinoma (MTC). To evaluate the ability of serum calcitonin to predict the extent of surgery needed in the lateral neck. This retrospective population-based cohort study includes data from 94 of 139 patients with MTC surgically treated in Norway from 2003 to 2016. Patients were identified in the 4 regional centers treating MTC and by the Cancer Registry of Norway, and grouped according to calcitonin levels. In 58 patients without distant metastases or disease progression to the next tumor level (NPNL), data were compared in prognostic groups (N0-NPNL), (N1a-NPNL), and (N1b-NPNL). At calcitonin levels ≤500, 501-1,000, and >1,000 pmol/L, metastatic lymph nodes in the lateral neck were found in 16, 50, and 71% of the patients, respectively. In the prognostic groups, 19% of N0-NPNL patients had calcitonin >500 pmol/L and 17% of N1b-NPNL patients had calcitonin ≤500 pmol/L. In multivariate analysis, factors predicting biochemical cure and calcitonin level ≤500 pmol/L were no metastatic lymph nodes in the lateral neck ( Basal calcitonin cannot predict the need for prophylactic lateral lymph node dissection in patients with MTC. Further prospective, randomized studies are warranted.
Sections du résumé
BACKGROUND
BACKGROUND
Preoperative predictors for the need of prophylactic lymph node dissection in the lateral neck have been studied in patients with medullary thyroid carcinoma (MTC).
OBJECTIVES
OBJECTIVE
To evaluate the ability of serum calcitonin to predict the extent of surgery needed in the lateral neck.
METHODS
METHODS
This retrospective population-based cohort study includes data from 94 of 139 patients with MTC surgically treated in Norway from 2003 to 2016. Patients were identified in the 4 regional centers treating MTC and by the Cancer Registry of Norway, and grouped according to calcitonin levels. In 58 patients without distant metastases or disease progression to the next tumor level (NPNL), data were compared in prognostic groups (N0-NPNL), (N1a-NPNL), and (N1b-NPNL).
RESULTS
RESULTS
At calcitonin levels ≤500, 501-1,000, and >1,000 pmol/L, metastatic lymph nodes in the lateral neck were found in 16, 50, and 71% of the patients, respectively. In the prognostic groups, 19% of N0-NPNL patients had calcitonin >500 pmol/L and 17% of N1b-NPNL patients had calcitonin ≤500 pmol/L. In multivariate analysis, factors predicting biochemical cure and calcitonin level ≤500 pmol/L were no metastatic lymph nodes in the lateral neck (
CONCLUSIONS
CONCLUSIONS
Basal calcitonin cannot predict the need for prophylactic lateral lymph node dissection in patients with MTC. Further prospective, randomized studies are warranted.
Identifiants
pubmed: 31259158
doi: 10.1159/000499018
pii: etj-0008-0159
pmc: PMC6587193
doi:
Types de publication
Journal Article
Langues
eng
Pagination
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