Is Prophylactic Lymphadenectomy Mandatory For Clinical N0 Medullary Thyroid Cancer? A Single Center Study
Thyroid World Congress ePoster Library. Santos P. 06/21/19; 272119; 172
Patricia Santos
Patricia Santos
Login now to access Regular content available to all registered users.

You may also access this content "anytime, anywhere" with the Free MULTILEARNING App for iOS and Android
Abstract
Rate & Comment (0)

Introduction:

Medullary thyroid carcinoma(MTC) accounts for 5-10% of all thyroid cancers and it’s known for its aggressive behaviour.

Material:

We reviewed 102 patients diagnosed and operated at Lisbon Portuguese Institute of Oncology, Francisco Gentil between 1990-2015 with MTC.Pathological and analytical features, demographic characteristics, procedures and survival rate were analyzed.

Results:

Of the total of 102 patients 85 were sporadic medullary thyroid cancer(SMTC) with a median follow-up time of 113 months. During this time, in SMTC, biochemical cure was obtained in 25 patients (29%) and 24 (28%) died. The survival rate at 5 years was 72%. 

In the SMTC group, from the 44 (52%) patients without clinical lymph node involvement (cN0), 22 (50%) underwent prophylactic lymphadenectomy; 27% (6) of those patients were N positive after histopathological examination (pN1). No pN1 (6) died and 2 had biochemical cure. In those pN0 (16), 1 died and 11 had biochemical cure.

The cN0 that underwent just total thyroidectomy 1(4%) died from the disease and 12 (54%) had biochemical cure.

It was also observed that cN0 patients with preoperative calcitonin over 28000 pg/ml, 100% where pN1 after lymphadenectomy. The cN0 without lymphadenectomy with preoperative calcitonin over 28000 pg/ml had biochemical persistent disease.The calcitonin value was correlated with tumor size.

Conclusion:

We observed that 27% of the cN0 had already ganglionar metastasis. In 73% (16) of cN0 that underwent lymphadenectomy, this procedure was unnecessary. Based on the calcitonin pre-operatory we can determine in the cN0 the patients who should be systematically submitted to lymphadenectomy. A larger sample is needed to conclude prognostic value of prophylactic lymphadenectomy. 

 


Introduction:

Medullary thyroid carcinoma(MTC) accounts for 5-10% of all thyroid cancers and it’s known for its aggressive behaviour.

Material:

We reviewed 102 patients diagnosed and operated at Lisbon Portuguese Institute of Oncology, Francisco Gentil between 1990-2015 with MTC.Pathological and analytical features, demographic characteristics, procedures and survival rate were analyzed.

Results:

Of the total of 102 patients 85 were sporadic medullary thyroid cancer(SMTC) with a median follow-up time of 113 months. During this time, in SMTC, biochemical cure was obtained in 25 patients (29%) and 24 (28%) died. The survival rate at 5 years was 72%. 

In the SMTC group, from the 44 (52%) patients without clinical lymph node involvement (cN0), 22 (50%) underwent prophylactic lymphadenectomy; 27% (6) of those patients were N positive after histopathological examination (pN1). No pN1 (6) died and 2 had biochemical cure. In those pN0 (16), 1 died and 11 had biochemical cure.

The cN0 that underwent just total thyroidectomy 1(4%) died from the disease and 12 (54%) had biochemical cure.

It was also observed that cN0 patients with preoperative calcitonin over 28000 pg/ml, 100% where pN1 after lymphadenectomy. The cN0 without lymphadenectomy with preoperative calcitonin over 28000 pg/ml had biochemical persistent disease.The calcitonin value was correlated with tumor size.

Conclusion:

We observed that 27% of the cN0 had already ganglionar metastasis. In 73% (16) of cN0 that underwent lymphadenectomy, this procedure was unnecessary. Based on the calcitonin pre-operatory we can determine in the cN0 the patients who should be systematically submitted to lymphadenectomy. A larger sample is needed to conclude prognostic value of prophylactic lymphadenectomy. 

 


    This eLearning portal is powered by:
    This eLearning portal is powered by MULTIEPORTAL
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.


Save Settings