Surgical Treatment of Medullary Thyroid Cancer.

Abstract

Medullary thyroid cancer (MTC) can vary in tumor biology and progression. The most important indicator of distant metastases, determining clinical outcome, is lymph node metastasis to the neck and mediastinum. Surgical cure is within reach in node-negative tumors or node-positive tumors with fewer than 10 lymph node metastases. From a surgical point of view, compartment-oriented lymph node dissection, clearing gross, and occult metastases are important for locoregional tumor control. The discovery of missense germline mutations in the RET proto-oncogene and the close genotype-phenotype correlation in hereditary MTC promoted the worldwide breakthrough of prophylactic thyroidectomy. The best approach to hereditary MTC affords the DNA-based/biochemical concept, which is geared at limiting prophylactic surgery to total thyroidectomy at minimal surgical morbidity before the tumor can spread beyond the thyroid capsule. To improve outcome, routine calcitonin screening in nodular thyroid disease and DNA-based screening of the offspring in RET families are effective interventions.

• Authors: Andreas Machens, Henning Dralle
• Journal: Recent results in cancer research. Fortschritte der Krebsforschung. Progres dans les recherches sur le cancer (Recent Results Cancer Res) Vol. 204 Pg. 187-205 ( 2015) ISSN: 0080-0015 [Print] Germany
• PMID: 26494390 (Publication Type: Journal Article, Review)

Chemical References

• MAS1 protein, human
• Proto-Oncogene Mas
• Proto-Oncogene Proteins c-ret
• RET protein, human

Topics

• Carcinoma, Neuroendocrine (genetics, secondary, surgery)
• Genetic Predisposition to Disease
• Heredity
• Humans
• Lymph Node Excision
• Lymphatic Metastasis
• Mutation
• Neoplasm Recurrence, Local
• Phenotype
• Proto-Oncogene Mas
• Proto-Oncogene Proteins c-ret (genetics)
• Reoperation
• Thyroid Neoplasms (genetics, pathology, surgery)
• Thyroidectomy
• Treatment Outcome