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Central Neck Dissection for Medullary Thyroid Carcinoma

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Endocrine and Neuroendocrine Surgery

Part of the book series: Springer Surgery Atlas Series ((SPRISURGERY))

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Abstract

Medullary thyroid carcinoma (MTC) is a malignancy that is characterized by a high proportion of hereditary cases and secretion of the tumor marker calcitonin [1]. MTCs are moderately invasive and have a high propensity for spread to cervical lymph nodes [2]. Central lymph nodes (level VI) are involved up to 81% of the time [3, 4]. Because MTC cells do not concentrate radioactive iodine, central neck dissection is a critical component of surgical management. Total thyroidectomy and central neck dissection (TT+CND) is recommended in the initial management of the patient with MTC [4]. Lateral neck dissection in these patients is described elsewhere in this volume (Chap. 9).

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References

  1. Pitt SC, Moley JF. Medullary, anaplastic, and metastatic cancers of the thyroid. Semin Oncol. 2010;37:567–79.

    Article  PubMed  Google Scholar 

  2. Moley JF. Medullary thyroid carcinoma: management of lymph node metastases. J Natl Compr Cancer Netw. 2010;8:549–56.

    Article  Google Scholar 

  3. Moley JF, DeBenedetti MK. Patterns of nodal metastases in palpable medullary thyroid carcinoma: recommendations for extent of node dissection. Ann Surg 1999;229:880–887; discussion 887–8.

    Google Scholar 

  4. Kloos RT, Eng C, Evans DB, Francis GL, Gagel R, Gharib H, et al. Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid. 2009;19:565–612.

    Article  PubMed  Google Scholar 

  5. Skinner MA, Moley JA, Dilley WG, Owzar K, Debenedetti MK, Wells Jr SA. Prophylactic thyroidectomy in multiple endocrine neoplasia type 2A. N Engl J Med. 2005;353:1105–13.

    Article  CAS  PubMed  Google Scholar 

  6. Miyauchi A, Matsuzuka F, Hirai K, Yokozawa T, Kobayashi K, Kuma S, et al. Unilateral surgery supported by germline RET oncogene mutation analysis in patients with sporadic medullary thyroid carcinoma. World J Surg. 2000;24:1367–72.

    Article  CAS  PubMed  Google Scholar 

  7. Miyauchi A, Matsuzuka F, Hirai K, Yokozawa T, Kobayashi K, Ito Y, et al. Prospective trial of unilateral surgery for nonhereditary medullary thyroid carcinoma in patients without germline RET mutations. World J Surg. 2002;26:1023–8.

    Article  PubMed  Google Scholar 

  8. American Thyroid Association Surgery Working Group, American Association of Endocrine Surgeons, American Academy of Otolaryngology-Head and Neck Surgery, American Head and Neck Society, Carty SE, Cooper DS, et al. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 2009;19:1153–8.

    Article  Google Scholar 

  9. Napolitano G, Romeo A, Vallone G, Rossi M, Cagini L, Antinolfi G, et al. How the preoperative ultrasound examination and BFI of the cervical lymph nodes modify the therapeutic treatment in patients with papillary thyroid cancer. BMC Surg. 2013;13(Suppl 2):S52.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Leboulleux S, Girard E, Rose M, Travagli JP, Sabbah N, Caillou B, et al. Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab. 2007;92:3590–4.

    Article  CAS  PubMed  Google Scholar 

  11. Solorzano CC, Evans DB. Same-day ultrasound guidance in reoperations for locally recurrent papillary thyroid cancer. Surgery. 2007;142:973–5.

    Article  PubMed  Google Scholar 

  12. Machens A, Dralle H. Biomarker-based risk stratification for previously untreated medullary thyroid cancer. J Clin Endocrinol Metab. 2010;95:2655–63.

    Article  CAS  PubMed  Google Scholar 

  13. Moley J, Dilley W, DeBenedetti M. Improved results of cervical reoperation for medullary thyroid carcinoma. Ann Surg. 1997;225:734–43.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Olson JA, DeBenedetti MK, Baumann DS, Wells SA. Parathyroid autotransplantation during thyroidectomy. Results of long-term follow-up. Ann Surg 1996;223:472–478; discussion 478–80.

    Google Scholar 

  15. Mazzaferri EL, Jhiang SM. Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer. Am J Med. 1994;97:418–28.

    Article  CAS  PubMed  Google Scholar 

  16. Scheumann GF, Gimm O, Wegener G, Hundeshagen H, Dralle H. Prognostic significance and surgical management of locoregional lymph node metastases in papillary thyroid cancer. World J Surg 1994;18:559–567; discussion 567–8.

    Google Scholar 

  17. Hughes CJ, Shaha AR, Shah JP, Loree TR. Impact of lymph node metastasis in differentiated carcinoma of the thyroid: a matched-pair analysis. Head Neck. 1996;18:127–32.

    Article  CAS  PubMed  Google Scholar 

  18. Barczynski M, Konturek A, Stopa M, Nowak W. Prophylactic central neck dissection for papillary thyroid cancer. Br J Surg. 2013;100:410–8.

    Article  CAS  PubMed  Google Scholar 

  19. Carling T, Long 3rd WD, Udelsman R. Controversy surrounding the role for routine central lymph node dissection for differentiated thyroid cancer. Curr Opin Oncol. 2009;22:30–4.

    Article  Google Scholar 

  20. Shan CX, Zhang W, Jiang DZ, Zheng XM, Liu S, Qiu M. Routine central neck dissection in differentiated thyroid carcinoma: a systematic review and meta-analysis. Laryngoscope. 2012;122:797–804.

    Article  PubMed  Google Scholar 

  21. Giordano D, Valcavi R, Thompson GB, Pedroni C, Renna L, Gradoni P, Barbieri V. Complications of central neck dissection in patients with papillary thyroid carcinoma: results of a study on 1087 patients and review of the literature. Thyroid. 2012;22:911–7.

    Article  PubMed  Google Scholar 

  22. Lombardi CP, Raffaelli M, De Crea C, Sessa L, Rampulla V, Bellantone R. Video-assisted versus conventional total thyroidectomy and central compartment neck dissection for papillary thyroid carcinoma. World J Surg. 2012;36:1225–30.

    Article  PubMed  Google Scholar 

  23. Lang BH, Tang AH, Wong KP, Shek TW, Wan KY, Lo CY. Significance of size of lymph node metastasis on postsurgical stimulated thyroglobulin levels after prophylactic unilateral central neck dissection in papillary thyroid carcinoma. Ann Surg Oncol. 2012;19:3472–8.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Sousa AA, Salles JM, Soares JM, Moraes GM, Carvalho J, Savassi-Rocha PR. Predictors factors for post-thyroidectomy hypocalcemia. Rev Col Bras Cir. 2012;39:476–82.

    Article  Google Scholar 

  25. Roh JL, Park JY, Park CI. Prevention of postoperative hypocalcemia with routine oral calcium and vitamin D supplements in patients with differentiated papillary thyroid carcinoma undergoing total thyroidectomy plus central neck dissection. Cancer. 2009;115:251–8.

    Article  CAS  PubMed  Google Scholar 

  26. Abboud B, Sleilaty G, Tannoury J, Daher R, Abadjian G, Ghorra C. Cervical neck dissection without drains in well-differentiated thyroid carcinoma. Am Surg. 2011;77:1624–8.

    PubMed  Google Scholar 

  27. Boudourakis LD, Wang TS, Roman SA, Desai R, Sosa JA. Evolution of the surgeon-volume, patient-outcome relationship. Ann Surg. 2009;250:159–65.

    Article  PubMed  Google Scholar 

  28. Sosa JA, Bowman HM, Tielsch JM, Powe NR, Gordon TA, Udelsman R. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg. 1998;228:320–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Moley JF, Fialkowski EA. Evidence-based approach to the management of sporadic medullary thyroid carcinoma. World J Surg. 2007;31:946–56.

    Article  PubMed  Google Scholar 

  30. Fialkowski E, DeBenedetti M, Moley J. Long-term outcome of reoperations for medullary thyroid carcinoma. World J Surg. 2008;32:754–65.

    Article  PubMed  Google Scholar 

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Correspondence to J. F. Moley .

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Moley, J.F. (2017). Central Neck Dissection for Medullary Thyroid Carcinoma. In: Howe, J. (eds) Endocrine and Neuroendocrine Surgery. Springer Surgery Atlas Series. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-54067-1_7

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  • DOI: https://doi.org/10.1007/978-3-662-54067-1_7

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