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Unilateral Surgery for Medullary Thyroid Carcinoma: Seeking for Clinical Practice Guidelines
Optimized preoperative diagnostic tools with calcitonin tests, ultrasound features, functional imaging modalities, and genetic testing to detect hereditary forms have led to an increased rate of earlier diagnosis and surgery for medullary thyroid cancer (MTC). This helps to adapt the primary surgery...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309363/ https://www.ncbi.nlm.nih.gov/pubmed/35898450 http://dx.doi.org/10.3389/fendo.2022.875875 |
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author | Zhang, Daqi Colombo, Carla Sun, Hui Kim, Hoon Yub Pino, Antonella De Leo, Simone Gazzano, Giacomo Persani, Luca Dionigi, Gianlorenzo Fugazzola, Laura |
author_facet | Zhang, Daqi Colombo, Carla Sun, Hui Kim, Hoon Yub Pino, Antonella De Leo, Simone Gazzano, Giacomo Persani, Luca Dionigi, Gianlorenzo Fugazzola, Laura |
author_sort | Zhang, Daqi |
collection | PubMed |
description | Optimized preoperative diagnostic tools with calcitonin tests, ultrasound features, functional imaging modalities, and genetic testing to detect hereditary forms have led to an increased rate of earlier diagnosis and surgery for medullary thyroid cancer (MTC). This helps to adapt the primary surgery to the tumor stage and avoid surgical overtreatment for localized tumor growth, i.e., deviating from the regularly recommended thyroidectomy with bilateral central lymph node dissection in favor of a limited unilateral approach. To limit primary surgical therapy, it is crucial that the MTC is clinically unifocal, sporadic, and confined to the thyroid, and that calcitonin levels indicate biochemical recovery after surgery. The main requirement for such a limited approach is the availability of frozen section studies that reliably indicate (i) R0 resection of the MTC, (ii) absence of infiltration of the organ capsule, (iii) lack of desmoplasia (i.e., evidence of the metastatic potential of the MTC), (iiii) absence of contralateral disease or precancerous lesions. Informed consent is mandatory from the patient, who has been fully informed of the advantages, disadvantages, and potential risks of not undergoing the “classic” surgical procedure. The aim of this article is to review the guidelines for the management of early-stage MTC. |
format | Online Article Text |
id | pubmed-9309363 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93093632022-07-26 Unilateral Surgery for Medullary Thyroid Carcinoma: Seeking for Clinical Practice Guidelines Zhang, Daqi Colombo, Carla Sun, Hui Kim, Hoon Yub Pino, Antonella De Leo, Simone Gazzano, Giacomo Persani, Luca Dionigi, Gianlorenzo Fugazzola, Laura Front Endocrinol (Lausanne) Endocrinology Optimized preoperative diagnostic tools with calcitonin tests, ultrasound features, functional imaging modalities, and genetic testing to detect hereditary forms have led to an increased rate of earlier diagnosis and surgery for medullary thyroid cancer (MTC). This helps to adapt the primary surgery to the tumor stage and avoid surgical overtreatment for localized tumor growth, i.e., deviating from the regularly recommended thyroidectomy with bilateral central lymph node dissection in favor of a limited unilateral approach. To limit primary surgical therapy, it is crucial that the MTC is clinically unifocal, sporadic, and confined to the thyroid, and that calcitonin levels indicate biochemical recovery after surgery. The main requirement for such a limited approach is the availability of frozen section studies that reliably indicate (i) R0 resection of the MTC, (ii) absence of infiltration of the organ capsule, (iii) lack of desmoplasia (i.e., evidence of the metastatic potential of the MTC), (iiii) absence of contralateral disease or precancerous lesions. Informed consent is mandatory from the patient, who has been fully informed of the advantages, disadvantages, and potential risks of not undergoing the “classic” surgical procedure. The aim of this article is to review the guidelines for the management of early-stage MTC. Frontiers Media S.A. 2022-07-11 /pmc/articles/PMC9309363/ /pubmed/35898450 http://dx.doi.org/10.3389/fendo.2022.875875 Text en Copyright © 2022 Zhang, Colombo, Sun, Kim, Pino, De Leo, Gazzano, Persani, Dionigi and Fugazzola https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Zhang, Daqi Colombo, Carla Sun, Hui Kim, Hoon Yub Pino, Antonella De Leo, Simone Gazzano, Giacomo Persani, Luca Dionigi, Gianlorenzo Fugazzola, Laura Unilateral Surgery for Medullary Thyroid Carcinoma: Seeking for Clinical Practice Guidelines |
title | Unilateral Surgery for Medullary Thyroid Carcinoma: Seeking for Clinical Practice Guidelines |
title_full | Unilateral Surgery for Medullary Thyroid Carcinoma: Seeking for Clinical Practice Guidelines |
title_fullStr | Unilateral Surgery for Medullary Thyroid Carcinoma: Seeking for Clinical Practice Guidelines |
title_full_unstemmed | Unilateral Surgery for Medullary Thyroid Carcinoma: Seeking for Clinical Practice Guidelines |
title_short | Unilateral Surgery for Medullary Thyroid Carcinoma: Seeking for Clinical Practice Guidelines |
title_sort | unilateral surgery for medullary thyroid carcinoma: seeking for clinical practice guidelines |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9309363/ https://www.ncbi.nlm.nih.gov/pubmed/35898450 http://dx.doi.org/10.3389/fendo.2022.875875 |
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