Changing the paradigm: lobectomy for sporadic medullary thyroid cancer
Authors' conclusion
This is the first European study that aims to evaluate the feasibility of lobectomy as first-line therapy for MTC based on the evaluation of thyroid US and serum Ct levels. These tools have been shown to have a good accuracy in detecting the affected lobe and strongly support the possibility to perform a more conservative surgery to treat RET-negative patients with suspicious MTC and nodular goiter.
Study context
- Population
- RET germline negative patients with medullary thyroid cancer (MTC) diagnosed in the past 30 years, treated with total thyroidectomy ± lymphadenectomy, followed in a tertiary care centresubgroup of 55 for ex-post criteria
- Participants
- 89 patients
- Exposure
- Monolateral goiter vs Bilateral goiter
- Outcome
- Performance of Ct, ultrasound scans (US) and cytology in preoperative identification of MTC; number of total thyroidectomies avoidable with preoperative MTC location
Methodological detailssingle tertiary care centre
- Single tertiary care centre
Main finding
As reported in the abstract
Nodules identified preoperatively as MTC by ex-post criteria
Monolateral goiter
84.4
%
Bilateral goiter
56.5%
Observational data: associations, not effects.
Further findings
Bilateral MTC at histology
- Bilateral MTC at histology
- 2/89 (2.2%)
Correlation of preoperative basal calcitonin (Ct) with MTC size
- Strongly significant correlation between preoperative basal Ct levels and MTC size
Original publication
Changing the paradigm: lobectomy for sporadic medullary thyroid cancer. Eur Thyroid J. Published 31 March 2025. doi:10.
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