Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study

Research output: Contribution to journalArticlepeer-review

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Multifocality in Sporadic Medullary Thyroid Carcinoma : An International Multicenter Study. / Essig, Garth F; Porter, Kyle; Schneider, David; Arpaia, Debora; Lindsey, Susan C; Busonero, Giulia; Fineberg, Daniel; Fruci, Barbara; Boelaert, Kristien; Smit, Johannes W; Meijer, Johannes Arnoldus Anthonius; Duntas, Leonidas H; Sharma, Neil; Costante, Giuseppe; Filetti, Sebastiano; Sippel, Rebecca S; Biondi, Bernadette; Topliss, Duncan J; Pacini, Furio; Maciel, Rui M B; Walz, Patrick C; Kloos, Richard T.

In: Thyroid, Vol. 26, No. 11, 11.2016, p. 1563-1572.

Research output: Contribution to journalArticlepeer-review

Harvard

Essig, GF, Porter, K, Schneider, D, Arpaia, D, Lindsey, SC, Busonero, G, Fineberg, D, Fruci, B, Boelaert, K, Smit, JW, Meijer, JAA, Duntas, LH, Sharma, N, Costante, G, Filetti, S, Sippel, RS, Biondi, B, Topliss, DJ, Pacini, F, Maciel, RMB, Walz, PC & Kloos, RT 2016, 'Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study', Thyroid, vol. 26, no. 11, pp. 1563-1572. https://doi.org/10.1089/thy.2016.0255

APA

Essig, G. F., Porter, K., Schneider, D., Arpaia, D., Lindsey, S. C., Busonero, G., Fineberg, D., Fruci, B., Boelaert, K., Smit, J. W., Meijer, J. A. A., Duntas, L. H., Sharma, N., Costante, G., Filetti, S., Sippel, R. S., Biondi, B., Topliss, D. J., Pacini, F., ... Kloos, R. T. (2016). Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study. Thyroid, 26(11), 1563-1572. https://doi.org/10.1089/thy.2016.0255

Vancouver

Essig GF, Porter K, Schneider D, Arpaia D, Lindsey SC, Busonero G et al. Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study. Thyroid. 2016 Nov;26(11):1563-1572. https://doi.org/10.1089/thy.2016.0255

Author

Essig, Garth F ; Porter, Kyle ; Schneider, David ; Arpaia, Debora ; Lindsey, Susan C ; Busonero, Giulia ; Fineberg, Daniel ; Fruci, Barbara ; Boelaert, Kristien ; Smit, Johannes W ; Meijer, Johannes Arnoldus Anthonius ; Duntas, Leonidas H ; Sharma, Neil ; Costante, Giuseppe ; Filetti, Sebastiano ; Sippel, Rebecca S ; Biondi, Bernadette ; Topliss, Duncan J ; Pacini, Furio ; Maciel, Rui M B ; Walz, Patrick C ; Kloos, Richard T. / Multifocality in Sporadic Medullary Thyroid Carcinoma : An International Multicenter Study. In: Thyroid. 2016 ; Vol. 26, No. 11. pp. 1563-1572.

Bibtex

@article{393ad32580c84b68abe47f4f303cb516,
title = "Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study",
abstract = "BACKGROUND: Current surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC, given their lower frequency of bilateral disease, although this topic has not been thoroughly studied. This study assessed the prevalence of multifocality in sMTC via a large international multi-institutional retrospective review to quantify this prevalence, including the impact of geography, to assess more accurately the risks associated with alternative surgical approaches.METHODS: A retrospective chart review of sMTC patients from 11 institutions over 29 years (1983-2011) was undertaken. Data regarding focality, extent of disease, RET germline analysis plus family and clinical history for multiple endocrine neoplasia type 2 (MEN2), and demographic data were collected and analyzed.RESULTS: Patients from four continents and seven countries were included in the sample. Data for 313 patients with documented sMTC were collected. Of these, 81.2% were confirmed with negative RET germline testing, while the remaining 18.8% demonstrated a negative family history and no manifestations of MEN2 syndromes other than MTC. Bilateral disease was identified in 17/306 (5.6%) patients, while multifocal disease was noted in 50/312 (16.0%) sMTC patients. When only accounting for germline negative patients, these rates were not significantly different (5.6% and 17%, respectively). Among them, when disease was unifocal in the ipsilateral lobe and isthmus, bilateral disease was present in 6/212 (2.8%) cases. When disease was multifocal in the ipsilateral lobe or isthmus, then bilateral disease was present in 8/37 (21.6%) cases (p < 0.001). No geographic differences in focality were identified.CONCLUSIONS: The 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard of care for initial surgery, as less complete thyroid surgery may fail to address fully the primary site of disease. Whether ipsilateral tumor focality should be an independent factor determining the need for completion thyroidectomy when sMTC is diagnosed after hemithyroidectomy remains to be determined.",
keywords = "Journal Article",
author = "Essig, {Garth F} and Kyle Porter and David Schneider and Debora Arpaia and Lindsey, {Susan C} and Giulia Busonero and Daniel Fineberg and Barbara Fruci and Kristien Boelaert and Smit, {Johannes W} and Meijer, {Johannes Arnoldus Anthonius} and Duntas, {Leonidas H} and Neil Sharma and Giuseppe Costante and Sebastiano Filetti and Sippel, {Rebecca S} and Bernadette Biondi and Topliss, {Duncan J} and Furio Pacini and Maciel, {Rui M B} and Walz, {Patrick C} and Kloos, {Richard T}",
year = "2016",
month = nov,
doi = "10.1089/thy.2016.0255",
language = "English",
volume = "26",
pages = "1563--1572",
journal = "Thyroid",
issn = "1050-7256",
publisher = "Mary Ann Liebert",
number = "11",

}

RIS

TY - JOUR

T1 - Multifocality in Sporadic Medullary Thyroid Carcinoma

T2 - An International Multicenter Study

AU - Essig, Garth F

AU - Porter, Kyle

AU - Schneider, David

AU - Arpaia, Debora

AU - Lindsey, Susan C

AU - Busonero, Giulia

AU - Fineberg, Daniel

AU - Fruci, Barbara

AU - Boelaert, Kristien

AU - Smit, Johannes W

AU - Meijer, Johannes Arnoldus Anthonius

AU - Duntas, Leonidas H

AU - Sharma, Neil

AU - Costante, Giuseppe

AU - Filetti, Sebastiano

AU - Sippel, Rebecca S

AU - Biondi, Bernadette

AU - Topliss, Duncan J

AU - Pacini, Furio

AU - Maciel, Rui M B

AU - Walz, Patrick C

AU - Kloos, Richard T

PY - 2016/11

Y1 - 2016/11

N2 - BACKGROUND: Current surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC, given their lower frequency of bilateral disease, although this topic has not been thoroughly studied. This study assessed the prevalence of multifocality in sMTC via a large international multi-institutional retrospective review to quantify this prevalence, including the impact of geography, to assess more accurately the risks associated with alternative surgical approaches.METHODS: A retrospective chart review of sMTC patients from 11 institutions over 29 years (1983-2011) was undertaken. Data regarding focality, extent of disease, RET germline analysis plus family and clinical history for multiple endocrine neoplasia type 2 (MEN2), and demographic data were collected and analyzed.RESULTS: Patients from four continents and seven countries were included in the sample. Data for 313 patients with documented sMTC were collected. Of these, 81.2% were confirmed with negative RET germline testing, while the remaining 18.8% demonstrated a negative family history and no manifestations of MEN2 syndromes other than MTC. Bilateral disease was identified in 17/306 (5.6%) patients, while multifocal disease was noted in 50/312 (16.0%) sMTC patients. When only accounting for germline negative patients, these rates were not significantly different (5.6% and 17%, respectively). Among them, when disease was unifocal in the ipsilateral lobe and isthmus, bilateral disease was present in 6/212 (2.8%) cases. When disease was multifocal in the ipsilateral lobe or isthmus, then bilateral disease was present in 8/37 (21.6%) cases (p < 0.001). No geographic differences in focality were identified.CONCLUSIONS: The 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard of care for initial surgery, as less complete thyroid surgery may fail to address fully the primary site of disease. Whether ipsilateral tumor focality should be an independent factor determining the need for completion thyroidectomy when sMTC is diagnosed after hemithyroidectomy remains to be determined.

AB - BACKGROUND: Current surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC, given their lower frequency of bilateral disease, although this topic has not been thoroughly studied. This study assessed the prevalence of multifocality in sMTC via a large international multi-institutional retrospective review to quantify this prevalence, including the impact of geography, to assess more accurately the risks associated with alternative surgical approaches.METHODS: A retrospective chart review of sMTC patients from 11 institutions over 29 years (1983-2011) was undertaken. Data regarding focality, extent of disease, RET germline analysis plus family and clinical history for multiple endocrine neoplasia type 2 (MEN2), and demographic data were collected and analyzed.RESULTS: Patients from four continents and seven countries were included in the sample. Data for 313 patients with documented sMTC were collected. Of these, 81.2% were confirmed with negative RET germline testing, while the remaining 18.8% demonstrated a negative family history and no manifestations of MEN2 syndromes other than MTC. Bilateral disease was identified in 17/306 (5.6%) patients, while multifocal disease was noted in 50/312 (16.0%) sMTC patients. When only accounting for germline negative patients, these rates were not significantly different (5.6% and 17%, respectively). Among them, when disease was unifocal in the ipsilateral lobe and isthmus, bilateral disease was present in 6/212 (2.8%) cases. When disease was multifocal in the ipsilateral lobe or isthmus, then bilateral disease was present in 8/37 (21.6%) cases (p < 0.001). No geographic differences in focality were identified.CONCLUSIONS: The 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard of care for initial surgery, as less complete thyroid surgery may fail to address fully the primary site of disease. Whether ipsilateral tumor focality should be an independent factor determining the need for completion thyroidectomy when sMTC is diagnosed after hemithyroidectomy remains to be determined.

KW - Journal Article

U2 - 10.1089/thy.2016.0255

DO - 10.1089/thy.2016.0255

M3 - Article

C2 - 27604949

VL - 26

SP - 1563

EP - 1572

JO - Thyroid

JF - Thyroid

SN - 1050-7256

IS - 11

ER -