Increased risk of lymph node metastasis in multifocal hereditary and sporadic medullary thyroid cancer.
World J Surg. 2007 Oct
Machens A, Hauptmann S, Dralle H.
Department of General, Visceral and Vascular Surgery, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str 40, D-06097, Halle/Saale, Germany. AndreasMachens@aol.com
Department of General, Visceral and Vascular Surgery, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, D-06097 Halle/Saale, Germany
Department of Pathology, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 14, D-06097 Halle/Saale, Germany
BACKGROUND: In sporadic and hereditary medullary thyroid cancer, tumor multifocality may constitute an independent risk factor of lymph node metastasis on top of primary tumor size when the diameter of the largest primary tumor is the same. METHODS: Included in this institutional cohort study were 232 consecutive patients operated on at our institution for hitherto untreated medullary thyroid cancer. Associations of clinicopathologic variables with lymph node metastasis were investigated simultaneously using multivariate Cox regression analysis.
RESULTS: On univariate analysis, multifocal cancers developed lymph node metastases significantly more often (p < or =" 0.005)" p =" 0.01)." or =" 3.1;">
CONCLUSION: The excess risk of lymph node metastasis of 34%-49% in multifocal medullary thyroid cancer seems to be caused by concurrent smaller thyroid cancers. A diagnosis of more than one medullary thyroid cancer signifies a higher risk of lymph node metastasis, warranting systematic lymph node dissection.Springer Link