We have located links that may give you full text access.
JOURNAL ARTICLE
META-ANALYSIS
RESEARCH SUPPORT, N.I.H., EXTRAMURAL
Biochemical cure after reoperations for medullary thyroid carcinoma: a meta-analysis.
Annals of Surgical Oncology 2015 January
BACKGROUND: Despite meticulous surgical techniques, calcitonin levels remain detectable in 40 % to 66 % of patients after initial surgery for medullary thyroid carcinoma (MTC), and the optimal surgical management for persistent or recurrent disease remains controversial. Previous studies suggest that biochemical cure, defined by normalization of postoperative calcitonin measurements, predicts disease-free survival. Reoperative approaches range from targeted removal of detectable disease to comprehensive compartment-oriented lymph node clearance.
METHODS: A proportional meta-analysis of clinical case series of postoperative calcitonin clearance after reoperation for MTC was performed. Studies were obtained from PubMed, Embase, Scopus, and the Cochrane Library.
RESULTS: Twenty-seven articles capturing data of 984 patients met the inclusion criteria for the meta-analysis. Overall, normalization of calcitonin after reoperation for MTC occurred in 16.2 % of patients [95 % confidence interval (CI) 14.0-18.5]. Stratified by operative procedure, targeted selective lymph node removal procedures had a normalization of calcitonin in 10.5 % of patients (95 % CI 6.4-14.7), while compartment-oriented procedures had a higher rate of normalization at 18.6 % (95 % CI 15.9-21.3).
CONCLUSIONS: The rate of calcitonin normalization after reoperation for MTC is enhanced through use of a meticulous compartment-oriented lymph node dissection. Compartment-oriented lymph node dissection results in calcitonin normalization in 18.6 % of reoperative MTC patients and is the procedure of choice in patients in whom the goal is biochemical cure.
METHODS: A proportional meta-analysis of clinical case series of postoperative calcitonin clearance after reoperation for MTC was performed. Studies were obtained from PubMed, Embase, Scopus, and the Cochrane Library.
RESULTS: Twenty-seven articles capturing data of 984 patients met the inclusion criteria for the meta-analysis. Overall, normalization of calcitonin after reoperation for MTC occurred in 16.2 % of patients [95 % confidence interval (CI) 14.0-18.5]. Stratified by operative procedure, targeted selective lymph node removal procedures had a normalization of calcitonin in 10.5 % of patients (95 % CI 6.4-14.7), while compartment-oriented procedures had a higher rate of normalization at 18.6 % (95 % CI 15.9-21.3).
CONCLUSIONS: The rate of calcitonin normalization after reoperation for MTC is enhanced through use of a meticulous compartment-oriented lymph node dissection. Compartment-oriented lymph node dissection results in calcitonin normalization in 18.6 % of reoperative MTC patients and is the procedure of choice in patients in whom the goal is biochemical cure.
Full text links
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app