This Article Full Text Full Text (PDF) All Versions of this Article: 90/4/2029    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Machens, A. Articles by Dralle, H. Search for Related Content PubMed PubMed Citation Articles by Machens, A. Articles by Dralle, H. Related Collections Endocrine Oncology Thyroid

Prospects of Remission in Medullary Thyroid Carcinoma According to Basal Calcitonin Level

Department of General, Visceral, and Vascular Surgery (A.M., H.D.), Department of Internal Medicine, Division of Endocrinology (U.S.), and Department of Pathology (H.-J.H.), Martin Luther University Halle-Wittenberg, D-06097 Halle/Saale, Germany

Address all correspondence and requests for reprints to: Dr. Andreas Machens, Department of General, Visceral, and Vascular Surgery, Martin Luther University Halle-Wittenberg, Ernst Grube Strasse 40, 06097 Halle/Saale, Germany. E-mail: gensurg{at}medizin.uni-halle.de.

Prediction of remission in medullary thyroid carcinoma (MTC) depends on histopathological information often unavailable before surgery. Simply requiring a venous blood sample, preoperative basal calcitonin levels may be a better indicator of remission. In this institutional series of 224 consecutive patients with MTC and elevated preoperative basal calcitonin levels, postoperative calcitonin levels normalized in 28 (62%) of 45 patients with node-negative MTC and in 18 (10%) of 177 patients with node-positive MTC. On multivariate analysis, preoperative basal calcitonin levels greater than 500 pg/ml best predicted the failure to achieve biochemical remission, followed by nodal metastasis and reoperative status. Cumulative rates of biochemical remission fell continuously with rising serum basal calcitonin in node-negative patients. Node-positive patients did not achieve biochemical remission when their preoperative basal calcitonin levels exceeded 3000 pg/ml. Nodal metastasis started emerging at basal calcitonin levels of 10–40 pg/ml (normal range, <10 pg/ml). Distant metastasis and extrathyroidal growth began appearing in patients with node-positive MTC at basal calcitonin levels of 150–400 pg/ml. There were no differences between patients with sporadic and hereditary MTC after adjusting for multiple testing. Preoperative basal calcitonin levels may thus help individualize the extent of surgery and postoperative follow-up intervals for MTC.

This article has been cited by other articles:

				A. Machens, S. Hauptmann, and H. Dralle Medullary Thyroid Cancer Responsiveness to Pentagastrin Stimulation: An Early Surrogate Parameter of Tumor Dissemination? J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2234 - 2238. [Abstract] [Full Text] [PDF]

				P. Miccoli, M. N Minuto, C. Ugolini, E. Molinaro, F. Basolo, P. Berti, A. Pinchera, and R. Elisei Clinically unpredictable prognostic factors in the outcome of medullary thyroid cancer Endocr. Relat. Cancer, December 1, 2007; 14(4): 1099 - 1105. [Abstract] [Full Text] [PDF]

				A. L. Giraudet, D. Vanel, S. Leboulleux, A. Auperin, C. Dromain, L. Chami, N. Ny Tovo, J. Lumbroso, N. Lassau, G. Bonniaud, et al. Imaging Medullary Thyroid Carcinoma with Persistent Elevated Calcitonin Levels J. Clin. Endocrinol. Metab., November 1, 2007; 92(11): 4185 - 4190. [Abstract] [Full Text] [PDF]

				A. Machens, J. Ukkat, S. Hauptmann, and H. Dralle Abnormal Carcinoembryonic Antigen Levels and Medullary Thyroid Cancer Progression: A Multivariate Analysis Arch Surg, March 1, 2007; 142(3): 289 - 293. [Abstract] [Full Text] [PDF]