Calcitonin estimation in patients with nodular goiter and its significance for early detection of MTC: european comments to the guidelines of the American Thyroid Association

Rossella Elisei,Cristina Romei

doi:10.1186/1756-6614-6-s1-s2

Rossella Elisei, Cristina Romei

Open Access

https://doi.org/10.1186/1756-6614-6-s1-s2

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Journal: Thyroid Research	Publication Date: Jan 1, 2013
Citations: 59	License type: cc-by

Affiliation: University of Pisa

Abstract

One of the most discussed and controversial issue in the management of thyroid nodules is the need to perform a routine measurement of serum Calcitonin (Ct) in all cases. The American Thyroid Association guidelines do not recommend in favor or against this procedure since they retain that there are not enough evidences that it can determine an advantage to the health outcomes of these patients. This is not the view of many European experts who met in Lisbon in 2009 at the European Thyroid Association-Cancer Research Network meeting to discuss all the still open controversial issues on the management of medullary thyroid cancer patients.This paper is focused on the routine measurement of serum Ct in all patients with thyroid nodule(s): the evidences, the rational and the benefits of this procedure are deeply analysed following the discussion that was done in Lisbon. The conclusions reached at that time are reported in detail.

Highlights

In 2009 the European Thyroid Association endorsed the American Thyroid association guidelines for the management of medullary thyroid cancer (MTC) affected patients [1]
The American Thyroid Association guidelines do not recommend in favor or against this procedure since they retain that there are not enough evidences that it can determine an advantage to the health outcomes of these patients
This is not the view of many European experts who met in Lisbon in 2009 at the European Thyroid Association-Cancer Research Network meeting to discuss all the still open controversial issues on the management of medullary thyroid cancer patients

Summary

Introduction

In 2009 the European Thyroid Association endorsed the American Thyroid association guidelines for the management of medullary thyroid cancer (MTC) affected patients [1]. It is worth to note that in 2010, independently from the ETA-CRN meeting in Lisbon discussion, a new document signed by the American Association of Clinical Endocrinologists (AACE), by the Associazione Medici Endocrinologici (AME) and by the European Thyroid Association (ETA) was published which declared that routine serum Ct may be useful, especially before surgery and strongly recommended its measurement in certain high-risk group [4]. Why is it important to measure serum Ct in nodular goiter for the EPE? European studies previously demonstrated that it is valuable [22,27] but, recently, a USA study revealed that routine Ct screening in patients with nodular goiter appeared to be cost-effective and in particular its cost-effectiveness resulted comparable to colonoscopy, and mammography screening [35]

Conclusions

30. Pacini F