Endocrine Abstracts

Based on the medical records of 311 patients with medullary thyroid carcinoma (MTC) treated in the period 1979–2018, using the Kaplan-Meier method, it was found that the sporadic form and male patients are negative predictors of disease. Other is essential for patients with sporadic form of MTC, because sex has no prognostic value in patients with hereditary forms of the disease. The presence of metastases in regional lymph nodes or distant metastases is a poor prognostic factor and analyzes the significance of the severity of the disease showed that patients belonging to the male sex are also a negative factor on prediction. In determining surgical treatment is necessary to consider the size of the tumor: the presence of carcinoma larger than 2 cm (even proved the absence of metastasis) increases mortality and reduces the survival of patients with MTC. In order to determine the need for prophylactic lateral neck lymph node dissection in patients with MTC with tumors of various sizes a retrospective analysis of the incidence of recurrence and mortality of patients depending on the amount of surgery. The study confirmed the idea that dominates the literature regarding mandatory extrafascial thyroidectomy even for tumors less than 2 cm. When the thyroidectomy and lateral (unilateral or bilateral), the frequency of neck dissection lymph node recurrence and mortality of patients were very high, due to frequent metastasis primarily in the central compartment lymph nodes neck. Rate of recurrence and mortality in patients after an isolated central dissection is low, and all cases of complications or death focused exclusively on patients with tumors larger than 2 cm. In case of the combined thyroidectomy and central and lateral lymph node dissection also observed a small amount of recurrence and death in patients: they were significantly lower compared to the group of patients who underwent thyroidectomy and lateral neck dissection, and is comparable with the group of patients who underwent central neck lymph node dissection. This is most clearly observed in the group of patients with tumors up to 2 cm. Based on the analysis concluded that the MTC larger than 2 cm, even in the absence of lymph node metastasis (from a survey of methods of topical diagnosis) is appropriate in conjunction with thyroidectomy and central spending also bilateral lymphadenectomy.