Fewer Cancer Reoperations for Medullary Thyroid Cancer After Initial Surgery According to ATA Guidelines

Hans H. G. Verbeek, Johannes A. A. Meijer, Wouter T. Zandee, Kelvin H. Kramp, Willem Sluiter, Johannes W. Smit, Job Kievit, Thera P. Links, John Th M. Plukker*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

9 Citations (Scopus)

Abstract

Surgery is still the only curative treatment for medullary thyroid cancer (MTC). We evaluated clinical outcome in patients with locoregional MTC with regard to adequacy of treatment following ATA guidelines and number of sessions to first intended curative surgery in different hospitals.

We reviewed all records of MTC patients (n = 184) treated between 1980 and 2010 in two tertiary referral centers in the Netherlands. Symptomatic MTC (palpable tumor or suspicious lymphadenopathy) patients without distant metastasis were included (n = 86). Patients were compared with regard to adequacy of surgery according to ATA recommendations, tumor characteristics, number of local cancer reoperations, biochemical cure, clinical disease-free survival (DFS), overall survival (OS), and complications.

Adherence to ATA guidelines resulted in fewer cancer-related reoperations (0.24 vs. 0.60; P = 0.027) and more biochemical cure (40.9 vs. 20 %; P = 0.038). Surgery according to ATA-guidelines on patients treated in referral centers was significantly more often adequate (59.2 vs. 26.7 %; P = 0.026). Tumor size and LN+ were the most important predictors for clinical recurrence [relative risk (RR) 4.1 (size > 40 mm) 4.1 (LN+) and death (RR 4.2 (size > 40 mm) 8.1 (LN+)].

ATA-compliant surgery resulted in fewer local reoperations and more biochemical cure. Patients in referral centers more often underwent adequate surgery according to ATA-guidelines. Size and LN+ were the most important predictors for DFS and OS.

Original languageEnglish
Pages (from-to)1207-1213
Number of pages7
JournalAnnals of Surgical Oncology
Volume22
Issue number4
DOIs
Publication statusPublished - Apr-2015

Keywords

  • CALCITONIN NORMALIZATION
  • CERVICAL REOPERATION
  • ROUTINE MEASUREMENT
  • PROGNOSTIC-FACTORS
  • BIOCHEMICAL CURE
  • SERUM CALCITONIN
  • NECK DISSECTION
  • CARCINOMA
  • MANAGEMENT
  • CLASSIFICATION

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