Reoperation in metastasizing medullary thyroid carcinoma: Is a tumor stage-oriented approach justified?☆

摘要: Abstract Background. Lymph node metastases (LNM) are very often found in medullary thyroid carcinoma. After primary therapy, elevated levels of calcitonin measurable many patients. Because the low sensitivity and specificity diagnostic tools to detect micrometastases, question remains whether an extended lymphadenectomy improves chance cure this approach should be tumor stage oriented. Methods. We analyzed results 36 patients with carcinoma consecutively reoperated from 1988 1996, performing microdissection all four locoregional lymph compartments. Results. Pathologic (pT) category was classified as pT1, n = 3; pT2, 22; pT3, 6; pT4, 5. LNM were 34 (94%). The cervicocentral compartment contained 85%, cervicolateral compartments 41% 54%, upper mediastinum 36%. Patients different pT did not differ rate LNM. Ipsilateral 50% 71% contralateral 14% 40%. Nine (35%) 26 without distant biochemically cured. In 10 (38%) level decreased more than 50%. Conclusions. almost always (94%) who have after therapy. metastases, four-compartment gives a 35%. A stage-oriented does seem justified.