Comparison of Outcome of Standarized or Non-standarized Operation in Treatment of Sporadic Medullary Thyroid Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIUWei-wei , DENGXian-zhao ,  FANYou-ben , KANGJie , WUBo , YANGZhi-li , ZHENGQi

Center of Thyroid and Parathyroid, Department of General Surgery, The Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai 200233, China;

Corresponding author：

FANYou-ben, Email: fanyouben2006@163.com

Keywords：

Medullary thyroid neoplasm; Standardized operation; Complications

DOI：

10.7507/1007-9424.20140335

Video：

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Objective To investigate the effect of surgery and influence of posttreatment with non-standardized and standardized operation by reviewing and analyzing the sporadic medullary thyroid carcinoma operation cases. Methods The clinical data of 26 patients with sporadic medullary thyroid carcinoma treated by surgery from January 2000 to March 2013 in this hospital were analyzed retrospectively.These patients were divided into non-standardized operation group and standardized operation group (total thyroidectomy with lymph node dissection) according to the operation models.The biochemical cure rate, the complication rates of recurrent laryngeal nerve injury and hypopara-thyroidism of these two groups were investigated and compared. Results The 1-year biochemical cure rate had no statistical difference between the non-standardized operation group and standardized operation group (84.21% versus 100%, χ²=1.249 4, P > 0.05), the 1-year recurrence rate was 15.79% and 0, respectively.The 5-year biochemical cure rate of the standardized operation group was significantly higher than that of the non-standardized operation group (100% versus 16.67%, χ²=4.444 4, P < 0.05).The 5-year recurrence rate was 0 and 83.33%, respectively.However, there was no obvious difference between the two groups on the injury rate of recurrent laryngeal nerve (χ²=0.070 8, P > 0.05), as well as the rate of hypoparathyroidism (χ²=2.722 7, P > 0.05). Conclusions Compared with the non-standardized model, the standardized operation model (total thyroidectomy with lymph node dissection) shows a higher cure rate and a lower recurrent rate, and it does not increase the complication rates of hypoparathyroidism and recurrent laryngeal nerve injury

Citation： LIUWei-wei, DENGXian-zhao, FANYou-ben, KANGJie, WUBo, YANGZhi-li, ZHENGQi. Comparison of Outcome of Standarized or Non-standarized Operation in Treatment of Sporadic Medullary Thyroid Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(11): 1408-1412. doi: 10.7507/1007-9424.20140335 Copy

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2.	Ferreira CV, Siqueira DR, Ceolin L, et al.Advanced medullary thyroid cancer:pathophysiology and management[J].Cancer Manag Res, 2013, 5:57-66.
3.	刘跃武, 王梦一.甲状腺髓样癌诊治的若干问题[J].临床外科杂志, 2012, 20(7):455-456.
4.	樊友本, 郭伯敏.以CEA增高为主要表现的甲状腺髓样癌一例[J].中华普通外科杂志, 2009, 24(6):513.
5.	Sugawara M, Ly T, Hershman JM.Medullary thyroid cancer-current treatment strategy, novel therapies and perspectives for the future[J].Horm Cancer, 2012, 3(5/6):218-226.
6.	Cummings AL, Goldfarb M.Thyroid carcinoma metastases to axillary lymph nodes:report of two rare cases of papillary and medullary thyroid carcinoma and literature review[J].Endocr Pract, 2014, 20(3):e34-e37.
7.	Braudao LG, Cavalheiro BG, Junqueira CR.Prognostic influence of clinical and pathological factors in medullary thyroid carcinoma:a study of 53 cases[J].Clinics (Sao Paulo), 2009, 64(9):849-856.
8.	唐平章.美国国立综合癌症网(NCCN)2010年版甲状腺肿瘤治疗指南解读[J].中国实用外科杂志, 2010, 30(10):856-858.
9.	Lupone G, Antonino A, Rosato A, et al.Surgical strategy for the treatment of sporadic medullary thyroid carcinoma:our experience[J].G Chir, 2012, 33(11/12):395-399.
10.	Stamatakos M, Paraskeva P, Stefanaki C, et al.Medullary thyroid carcinoma:The third most common thyroid cancer reviewed[J].Oncol Lett, 2011, 2(1):49-53.
11.	Pinto AE, Silva GL, Henrique R, et al.Familial vs sporadic papillary thyroid carcinoma:a matched-case comparative study showing similar clinical/prognostic behaviour[J].Eur J Endocrinol, 2014, 170(2):321-327.
12.	Alevizaki M, Saltiki K, Rentziou GA, et al.Medullary thyroid carcinoma:the influence of policy changing in clinical characteristics and disease progression[J].Eur J Endocrinol, 2012, 167(6):799-808.
13.	Milan SA, Sosa JA, Roman SA.Current management of medullary thyroid cancer[J].Minerva Chir, 2010, 65(1):27-37.
14.	Moo-Young TA, Traugott AL, Moley JF.Sporadic and familial medullary thyroid carcinoma:state of the art[J].Surg Clin North Am, 2009, 89(5):1193-1204.
15.	Stamatakos M, Paraskeva P, Katsaronis P, et al.Surgical approach to the management of medullary thyroid cancer:when is lymph node dissection needed?[J].Oncology, 2013, 84(6):350-355.
16.	Welch K, McHenry CR.Selective lateral compartment neck dissection for thyroid cancer[J].J Surg Res, 2013, 184(1):193-199.
17.	Ma SH, Liu QJ, Zhang YC, et al.Alternative surgical strategies in patients with sporadic medullary thyroid carcinoma:Long-term follow-up[J].Oncol Lett, 2011, 2(5):975-980.
18.	张再兴, 李正江, 唐平章, 等.甲状腺髓样癌的外科治疗及预后分析[J].中华耳鼻咽喉头颈外科杂志, 2011, 46(3):209-213.
19.	Dralle H, Musholt TJ, Schabram JA, et al.German Association of Endocrine Surgeons Practice Guideline for the surgical management of malignant thyroid tumors[J].Langenbecks Arch Surg, 2013, 398(3):347-375.
20.	De Crea C, Raffaelli M, Milano V, et al.Is intraoperative calcitonin monitoring useful to modulate the extension of neck dissection in patients with medullary thyroid carcinoma?[J].World J Surg, 2014, 38(3):568-575.
21.	Machens A, Dralle H.Biomarker-based risk stratification for previously untreated medullary thyroid cancer[J].J Clin Endocrinol Metab, 2010, 95(6):2655-2663.
22.	Essig GF Jr, Porter K, Schneider D, et al.Fine needle aspiration and medullary thyroid carcinoma:the risk of inadequate preoperative evaluation and initial surgery when relying upon FNAB cytology alone[J].Endocr Pract, 2013, 19(6):920-927.
23.	Pusztaszeri MP, Bongiovanni M, Faquin WC.Update on the cytologic and molecular features of medullary thyroid carcinoma[J].Adv Anat Pathol, 2014, 21(1):26-35.
24.	Machens A, Dralle H.Benefit-risk balance of reoperation for persistent medullary thyroid cancer[J].Ann Surg, 2013, 257(4):751-757.
25.	Martínez-Rodríguez I, Banzo I, Carril JM.Metabolic response demonstrated by 18F-FDG-PET/CT in metastatic medullary thyroid carcinoma under sorafenib therapy[J].Endocrine, 2013, 44(1):264-265.
26.	Slavikova K, Montravers F, Treglia G, et al.What is currently the best radiopharmaceutical for the hybrid PET/CT detection of recurrent medullary thyroid carcinoma?[J].Curr Radiopharm, 2013, 6(2):96-105.

1. Moley JF, Fialkowski EA.Evidence-based approach to the management of sporadic medullary thyroid carcinoma[J].World J Surg, 2007, 31(5):946-956.
2. Ferreira CV, Siqueira DR, Ceolin L, et al.Advanced medullary thyroid cancer:pathophysiology and management[J].Cancer Manag Res, 2013, 5:57-66.
3. 刘跃武, 王梦一.甲状腺髓样癌诊治的若干问题[J].临床外科杂志, 2012, 20(7):455-456.
4. 樊友本, 郭伯敏.以CEA增高为主要表现的甲状腺髓样癌一例[J].中华普通外科杂志, 2009, 24(6):513.
5. Sugawara M, Ly T, Hershman JM.Medullary thyroid cancer-current treatment strategy, novel therapies and perspectives for the future[J].Horm Cancer, 2012, 3(5/6):218-226.
6. Cummings AL, Goldfarb M.Thyroid carcinoma metastases to axillary lymph nodes:report of two rare cases of papillary and medullary thyroid carcinoma and literature review[J].Endocr Pract, 2014, 20(3):e34-e37.
7. Braudao LG, Cavalheiro BG, Junqueira CR.Prognostic influence of clinical and pathological factors in medullary thyroid carcinoma:a study of 53 cases[J].Clinics (Sao Paulo), 2009, 64(9):849-856.
8. 唐平章.美国国立综合癌症网(NCCN)2010年版甲状腺肿瘤治疗指南解读[J].中国实用外科杂志, 2010, 30(10):856-858.
9. Lupone G, Antonino A, Rosato A, et al.Surgical strategy for the treatment of sporadic medullary thyroid carcinoma:our experience[J].G Chir, 2012, 33(11/12):395-399.
10. Stamatakos M, Paraskeva P, Stefanaki C, et al.Medullary thyroid carcinoma:The third most common thyroid cancer reviewed[J].Oncol Lett, 2011, 2(1):49-53.
11. Pinto AE, Silva GL, Henrique R, et al.Familial vs sporadic papillary thyroid carcinoma:a matched-case comparative study showing similar clinical/prognostic behaviour[J].Eur J Endocrinol, 2014, 170(2):321-327.
12. Alevizaki M, Saltiki K, Rentziou GA, et al.Medullary thyroid carcinoma:the influence of policy changing in clinical characteristics and disease progression[J].Eur J Endocrinol, 2012, 167(6):799-808.
13. Milan SA, Sosa JA, Roman SA.Current management of medullary thyroid cancer[J].Minerva Chir, 2010, 65(1):27-37.
14. Moo-Young TA, Traugott AL, Moley JF.Sporadic and familial medullary thyroid carcinoma:state of the art[J].Surg Clin North Am, 2009, 89(5):1193-1204.
15. Stamatakos M, Paraskeva P, Katsaronis P, et al.Surgical approach to the management of medullary thyroid cancer:when is lymph node dissection needed?[J].Oncology, 2013, 84(6):350-355.
16. Welch K, McHenry CR.Selective lateral compartment neck dissection for thyroid cancer[J].J Surg Res, 2013, 184(1):193-199.
17. Ma SH, Liu QJ, Zhang YC, et al.Alternative surgical strategies in patients with sporadic medullary thyroid carcinoma:Long-term follow-up[J].Oncol Lett, 2011, 2(5):975-980.
18. 张再兴, 李正江, 唐平章, 等.甲状腺髓样癌的外科治疗及预后分析[J].中华耳鼻咽喉头颈外科杂志, 2011, 46(3):209-213.
19. Dralle H, Musholt TJ, Schabram JA, et al.German Association of Endocrine Surgeons Practice Guideline for the surgical management of malignant thyroid tumors[J].Langenbecks Arch Surg, 2013, 398(3):347-375.
20. De Crea C, Raffaelli M, Milano V, et al.Is intraoperative calcitonin monitoring useful to modulate the extension of neck dissection in patients with medullary thyroid carcinoma?[J].World J Surg, 2014, 38(3):568-575.
21. Machens A, Dralle H.Biomarker-based risk stratification for previously untreated medullary thyroid cancer[J].J Clin Endocrinol Metab, 2010, 95(6):2655-2663.
22. Essig GF Jr, Porter K, Schneider D, et al.Fine needle aspiration and medullary thyroid carcinoma:the risk of inadequate preoperative evaluation and initial surgery when relying upon FNAB cytology alone[J].Endocr Pract, 2013, 19(6):920-927.
23. Pusztaszeri MP, Bongiovanni M, Faquin WC.Update on the cytologic and molecular features of medullary thyroid carcinoma[J].Adv Anat Pathol, 2014, 21(1):26-35.
24. Machens A, Dralle H.Benefit-risk balance of reoperation for persistent medullary thyroid cancer[J].Ann Surg, 2013, 257(4):751-757.
25. Martínez-Rodríguez I, Banzo I, Carril JM.Metabolic response demonstrated by 18F-FDG-PET/CT in metastatic medullary thyroid carcinoma under sorafenib therapy[J].Endocrine, 2013, 44(1):264-265.
26. Slavikova K, Montravers F, Treglia G, et al.What is currently the best radiopharmaceutical for the hybrid PET/CT detection of recurrent medullary thyroid carcinoma?[J].Curr Radiopharm, 2013, 6(2):96-105.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of Outcome of Standarized or Non-standarized Operation in Treatment of Sporadic Medullary Thyroid Carcinoma

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