Timing and extension of lymphadenectomy in medullary thyroid carcinoma: A case series from a single institution

INTERNATIONAL JOURNAL OF SURGERY

卷:41

Article

Polistena, Andrea¹  Sanguinetti, Alessandro¹  Lucchini, Roberta¹  Galasse, Sergio¹  Monacelli, Massimo¹  Avenia, Stefano¹  Boccolini, Andrea¹  Johnson, Louis Banka²  Avenia, Nicola¹ 

[1] Univ Perugia, Med Sch, Endocrine Surg Unit, S Maria Univ Hosp, Terni, Italy

[2] Lund Univ, Surg Dept, Skane Univ Hosp, Malmo, Sweden

关键词: Medullary;    Thyroid;    Carcinoma;    Lymph node;    Metastases;    Surgery;    Ultrasound;   

DOI  :  10.1016/j.ijsu.2017.04.026

来源: Elsevier

【 摘 要 】

Background: Medullary thyroid carcinoma is an aggressive tumor and presents with significant morbidity and mortality and a high rate of lymph node metastases. The combination of total thyroidectomy and cervical lymphadenectomy is the essential treatment for those patients presenting with cervical lymph node metastases. Materials and methods: A retrospective analysis of 117 patients operated for medullary thyroid carcinoma over a period of 15 years at a single institution. Surgical complications and calcitonin levels were noted. Results: Nodal metastases were detected in the central compartment in 72.6% patients. Positive lymph nodes were detected in the lateral compartment of 34 patients who had undergone ipsilateral dissection and in all 10 patients of those with bilateral surgery. We found 3 cases of unilateral transient recurrent laryngeal nerve palsy, 15 cases of temporary hypoparathyroidism, a permanent accessory nerve lesion and a case of chylous fistula. Normalization of post-operative calcitonin was found in 82.6% and of patients who underwent total thyroidectomy and central neck dissection alone compared to 35.4% in those with ipsilateral and bilateral neck dissection. Conclusions: Total thyroidectomy and cervical lymphadenectomy planned on the ultrasound preoperative study and on the calcitonin level represent the standard of treatment for medullary thyroid carcinoma. (C) 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

【 授权许可】

Free