The Treatment Outcomes of Medullary Thyroid Carcinoma

Abstract

Received December 23, 2011 Revised February 16, 2012 Accepted February 21, 2012 Address for correspondence Kang Dae Lee, MD Department of OtolaryngologyHead and Neck Surgery, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan 602-702, Korea Tel +82-51-990-6248 Fax +82-51-245-8539 E-mail kosinent@yahoo.co.kr Background and ObjectivesZZThe aim of this study was to evaluate the treatment outcomes of medullary thyroid carcinoma (MTC) by retrospective data analysis. Subjects and MethodZZWe conducted a retrospective chart review of 17 cases of pathologically proven MTC patients who were treated from 1998 to 2010 at the department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine. ResultsZZThe mean tumor size was 2.32 cm (0.5-3.4 cm). Seventy-one percent of patients were diagnosed with advanced stage (III or IV) of MTC. We performed RET genetic screening in 8 of 17 patients. Hereditary MTC was found in 3 of 17 patients (18%) and sporadic MTC was found in 14 of 17 (82%). The preoperative assessment of basal serum calcitonin (CT) level was performed in 15 of 17 patents. Eleven patients had elevated basal calcitonin levels (>13 pg/ mL). After the operation for MTC, the serum CT levels were elevated in 7 patients. Overall 5-year survival rate was 94%. Normalization of serum calcitonin level was accomplished more frequently in the absence of extra thyroidal invasion (p=0.034), multifocal tumor (p=0.02). ConclusionZZThe initial treatment of MTC is total thyroidectomy with central compartment neck dissection with or without lateral neck dissection. To detect recurrence or metastasis, regular checking of serum calcitonin is necessary. A better knowledge of prognostic factors could improve the management of MTC patients. Korean J Otorhinolaryngol-Head Neck Surg 2012;55:166-72