Progress in diagnosis and treatment of lateral cervical lymph node dissection in medullary thyroid carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GU Yanzhong ¹ , YANG Rui ² , WU Hongji ³ ,  ZHENG Haitao ⁴

1. The Second School of Clinical Medicine of Binzhou Medical University, Yantai, Shandong 264003, P. R. China;
2. School of Clinical Medicine of Weifang Medical University, Weifang, Shandong 261000, P. R. China;
3. The Fourth School of Clinical Medicine of Qingdao University, Yantai, Shandong 264000, P. R. China;
4. Department of Thyroid Surgery, Yantai Yuhuangding Hospital, Yantai, Shandong 264000, P. R. China;

Corresponding author：

ZHENG Haitao, Email: zhenghaitao1972@126.com

Keywords：

medullary thyroid carcinoma; lateral cervical lymph node metastasis; lateral cervical lymph node dissection

DOI：

10.7507/1007-9424.202305038

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To summarize the research progress on diagnostic criteria of lymph node metastasis in medullary thyroid carcinoma (MTC), and the indication and scope of lateral cervical lymph node dissection (LCLND). Method By searching PubMed and CNKI databases, the related guidelines and literature about the diagnosis and treatment of lateral cervical lymph node metastasis in MTC in recent years were obtained and reviewed. Results The metastatic rate of lateral cervical lymph nodes in MTC patients was high. The indication of LCLND was both consensus and controversy. The LCLND of MTC was also controversial, and the focus of controversy mainly focused on the survival rate, recurrence rate, distant metastasis and postoperative complications of patients receiving prophylactic LCLND. Different imaging methods had their own advantages and disadvantages in diagnosing lymph node metastasis of MTC. Nuclear medicine was effective but expensive. Fine needle puncture was also an effective method for the diagnosis of lymph node metastasis of MTC. At present, calcitonin level, tumor size and lymph node metastasis were still important indicators for evaluating MTC for prophylactic LCLND, but the application of related indications had not been unified. Many scholars recommended comprehensive consideration of various indicators to evaluate whether MTC carried out preventive LCLND. Conclusions The LCLND of MTC needs to be further explored and standardized on the basis of the existing consensus. The focus of prophylactic LCLND should be to improve the survival rate of patients while reducing complications as much as possible.

Citation： GU Yanzhong, YANG Rui, WU Hongji, ZHENG Haitao. Progress in diagnosis and treatment of lateral cervical lymph node dissection in medullary thyroid carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(10): 1273-1280. doi: 10.7507/1007-9424.202305038 Copy

1.	Szabo Yamashita T, Rogers RT, Foster TR, et al. Medullary thyroid cancer: What is the optimal management of the lateral neck in a node negative patient at index operation?. Surgery, 2022, 171(1): 177-181.
2.	Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet, 2016, 388(10061): 2783-2795.
3.	Wells SA, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid, 2015, 25(6): 567-610.
4.	Haddad RI, Bischoff L, Ball D, et al. Thyroid carcinoma, version 2.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2022, 20(8): 925-951.
5.	Filetti S, Durante C, Hartl D, et al. Thyroid cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2019, 30(12): 1856-1883.
6.	Saltiki K, Simeakis G, Karapanou O, et al. Management of endocrine disease: medullary thyroid cancer: from molecular biology and therapeutic pitfalls to future targeted treatment perspectives. Eur J Endocrinol, 2022, 187(3): R53-R63. doi: 10.1530/EJE-22-0312.
7.	Kaliszewski K, Ludwig M, Ludwig B, et al. Update on the diagnosis and management of medullary thyroid cancer: What has changed in recent years? Cancers (Basel), 2022, 14(15): 3643. doi: 10.3390/cancers14153643.
8.	Jayasinghe R, Basnayake O, Jayarajah U, et al. Management of medullary carcinoma of the thyroid: a review. J Int Med Res, 2022, 50(7): 3000605221110698. doi:10.1177/03000605221110698.
9.	Fugazzola L. Medullary thyroid cancer—An update. Best Pract Res Clin Endocrinol Metab, 2023, 37(1): 101655.
10.	Baloch ZW, Asa SL, Barletta JA, et al. Overview of the 2022 WHO classification of thyroid neoplasms. Endocr Pathol, 2022, 33(1): 27-63.
11.	Kim M, Kim BH. Current guidelines for management of medullary thyroid carcinoma. Endocrinol Metab (Seoul), 2021, 36(3): 514-524.
12.	Frisco NA, Gunn AH, Wang F, et al. Guideline adherence and practice patterns in the management of medullary thyroid cancer. J Surg Res, 2023, 281: 214-222.
13.	Fritz C, De Ravin E, Suresh N, et al. Clinical practice guidelines for management of medullary thyroid carcinoma: An AGREEⅡ appraisal. Am J Otolaryngol, 2022, 43(6): 103606.
14.	Machens A, Hauptmann S, Dralle H. Increased risk of lymph node metastasis in multifocal hereditary and sporadic medullary thyroid cancer. World J Surg, 2007, 31(10): 1960-1965.
15.	Machens A, Schneyer U, Holzhausen HJ, et al. Prospects of remission in medullary thyroid carcinoma according to basal calcitonin level. J Clin Endocrinol Metab, 2005, 90(4): 2029-2034.
16.	Fialkowski EA, Moley JF. Current approaches to medullary thyroid carcinoma, sporadic and familial. J Surg Oncol, 2006, 94(8): 737-747.
17.	Park JH, Lee YS, Kim BW, et al. Skip lateral neck node metastases in papillary thyroid carcinoma. World J Surg, 2012, 36(4): 743-747.
18.	Brammen L, Niederle MB, Riss P, et al. Medullary thyroid carcinoma: Do ultrasonography and F-DOPA-PET-CT influence the initial surgical strategy? Ann Surg Oncol, 2018, 25(13): 3919-3927.
19.	Kushchayev SV, Kushchayeva YS, Tella SH, et al. Medullary thyroid carcinoma: An update on imaging. J Thyroid Res, 2019, 2019: 1893047.
20.	Traylor KS. Computed tomography and MR imaging of thyroid disease. Radiol Clin North Am, 2020, 58(6): 1059-1070.
21.	Marques B, Cunha N, Martins RG, et al. Lymph node metastases of medullary thyroid cancer: role of calcitonin in the washout fluid of fine-needle aspiration. Int J Endocrinol, 2020, 2020: 9267972.
22.	Ciarletto AM, Narick C, Malchoff CD, et al. Analytical and clinical validation of pairwise microRNA expression analysis to identify medullary thyroid cancer in thyroid fine-needle aspiration samples. Cancer Cytopathol, 2021, 129(3): 239-249.
23.	Riddle ND, Bui MM. Fibrous dysplasia. Arch Pathol Lab Med, 2013, 137(1): 134-138.
24.	Klain M, Hadoux J, Nappi C, et al. Imaging medullary thyroid cancer patients with detectable serum markers: state of the art and future perspectives. Endocrine, 2022, 75(2): 330-337.
25.	Giovanella L, Treglia G, Iakovou I, et al. EANM practice guideline for PET/CT imaging in medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging, 2020, 47(1): 61-77.
26.	Castinetti F, Taïeb D. Positron emission tomography imaging in medullary thyroid carcinoma: time for reappraisal? Thyroid, 2021, 31(2): 151-155.
27.	Treglia G, Sadeghi R, Giovinazzo F, et al. PET with different radiopharmaceuticals in neuroendocrine neoplasms: An umbrella review of published meta-analyses. Cancers (Basel), 2021, 13(20): 5172.
28.	Sesti A, Mayerhoefer M, Weber M, et al. Relevance of calcitonin cut-off in the follow-up of medullary thyroid carcinoma for conventional imaging and 18-fluorine-fluorodihydroxyphenylalanine PET. Anticancer Res, 2014, 34(11): 6647-6654.
29.	Romero-Lluch AR, Cuenca-Cuenca JI, Guerrero-Vázquez R, et al. Diagnostic utility of PET/CT with ¹⁸F-DOPA and ¹⁸F-FDG in persistent or recurrent medullary thyroid carcinoma: the importance of calcitonin and carcinoembryonic antigen cutoff. Eur J Nucl Med Mol Imaging, 2017, 44(12): 2004-2013.
30.	Treglia G, Castaldi P, Villani MF, et al. Comparison of ¹⁸F-DOPA, ¹⁸F-FDG and ⁶⁸Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging, 2012, 39(4): 569-580.
31.	Ong SC, Schöder H, Patel SG, et al. Diagnostic accuracy of ¹⁸F-FDG PET in restaging patients with medullary thyroid carcinoma and elevated calcitonin levels. J Nucl Med, 2007, 48(4): 501-507.
32.	Castroneves LA, Coura Filho G, de Freitas RMC, et al. Comparison of ⁶⁸Ga PET/CT to other imaging studies in medullary thyroid cancer: superiority in detecting bone metastases. J Clin Endocrinol Metab, 2018, 103(9): 3250-3259.
33.	Bodet-Milin C, Faivre-Chauvet A, Carlier T, et al. Anti-CEA pretargeted immuno-PET shows higher sensitivity than DOPA PET/CT in detecting relapsing metastatic medullary thyroid carcinoma: Post hoc analysis of the iPET-MTC study. J Nucl Med, 2021, 62(9): 1221-1227.
34.	Machens A, Hauptmann S, Dralle H. Prediction of lateral lymph node metastases in medullary thyroid cancer. Br J Surg, 2008, 95(5): 586-591.
35.	Machens A, Dralle H. Biomarker-based risk stratification for previously untreated medullary thyroid cancer. J Clin Endocrinol Metab, 2010, 95(6): 2655-2663.
36.	Dackiw AP. The surgical management of medullary thyroid cancer. Otolaryngol Clin North Am, 2010, 43(2): 365-374.
37.	Green K, Hintze J, O’Neill JP. Surgical aspects and controversies in the management of medullary thyroid cancer. Ir J Med Sci, 2022, 191(6): 2461-2466.
38.	Ito Y, Onoda N, Okamoto T. The revised clinical practice guidelines on the management of thyroid tumors by the Japan Associations of Endocrine Surgeons: Core questions and recommendations for treatments of thyroid cancer. Endocr J, 2020, 67(7): 669-717.
39.	Asarkar A, Chang BA, Nathan CO. What is the extent of neck dissection in medullary thyroid carcinoma? Laryngoscope, 2021, 131(3): 458-459.
40.	Viola D, Elisei R. Management of medullary thyroid cancer. Endocrinol Metab Clin North Am, 2019, 48(1): 285-301.
41.	Pavlidis E, Sapalidis K, Chatzinikolaou F, et al. Medullary thyroid cancer: molecular factors, management and treatment. Rom J Morphol Embryol, 2020, 61(3): 681-686.
42.	Mitchell AL, Gandhi A, Scott-Coombes D, et al. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol, 2016, 130(S2): S150-S160. doi: 10.1017/S0022215116000578.
43.	中国医师协会外科医师分会甲状腺外科医师委员会, 中国抗癌协会甲状腺癌专业委员会, 中国研究型医院学会甲状腺疾病专业委员会. 甲状腺髓样癌诊断与治疗中国专家共识(2020版). 中国实用外科杂志, 2020, 40(9): 1012-1020.
44.	Bowen A, Mani N, Penney S, et al. Surgical management of medullary thyroid cancer: which guidelines should we follow?. J Laryngol Otol, 2015, 129(5): 478-483.
45.	Stamatakos M, Paraskeva P, Katsaronis P, et al. Surgical approach to the management of medullary thyroid cancer: when is lymph node dissection needed?. Oncology, 2013, 84(6): 350-355.
46.	Ahn HS, Kim DW, Lee YJ, et al. Postoperative neck ultraso-nography surveillance after thyroidectomy in patients with medullary thyroid carcinoma: A multicenter study. Front Endocrinol (Lausanne), 2018, 9: 102.
47.	Zhou TH, Zhao LQ, Zhang Y, et al. The prediction of metastases of lateral cervical lymph node in medullary thyroid carcinoma. Front Endocrinol (Lausanne), 2021, 12: 741289.
48.	Jin L, Zhang X, Ni S, et al. A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer. Front Endocrinol (Lausanne), 2022, 13: 902546.
49.	Kaserer K, Scheuba C, Neuhold N, et al. Sporadic versus familial medullary thyroid microcarcinoma: a histopathologic study of 50 consecutive patients. Am J Surg Pathol, 2001, 25(10): 1245-1251.
50.	Niederle MB, Riss P, Selberherr A, et al. Omission of lateral lymph node dissection in medullary thyroid cancer without a desmoplastic stromal reaction. Br J Surg, 2021, 108(2): 174-181.
51.	Opsahl EM, Akslen LA, Schlichting E, et al. The role of calcitonin in predicting the extent of surgery in medullary thyroid carcinoma: A nationwide population-based study in Norway. Eur Thyroid J, 2019, 8(3): 159-166.
52.	Modigliani E, Cohen R, Campos JM, et al. Prognostic factors for survival and for biochemical cure in medullary thyroid carcinoma: results in 899 patients. The GETC Study Group. Groupe d'étude des tumeurs à calcitonine. Clin Endocrinol (Oxf), 1998, 48(3): 265-273.
53.	Lindsey SC, Ganly I, Palmer F, et al. Response to initial therapy predicts clinical outcomes in medullary thyroid cancer. Thyroid, 2015, 25(2): 242-249.
54.	Franc S, Niccoli-Sire P, Cohen R, et al. Complete surgical lymph node resection does not prevent authentic recurrences of medullary thyroid carcinoma. Clin Endocrinol (Oxf), 2001, 55(3): 403-409.
55.	Ahn SH, Chung EJ. Significance of neck dissection for the treatment of clinically-evident medullary thyroid carcinomas: A systematic review. Auris Nasus Larynx, 2019, 46(3): 417-423.
56.	Tuttle RM, Ganly I. Risk stratification in medullary thyroid cancer: moving beyond static anatomic staging. Oral Oncol, 2013, 49(7): 695-701.
57.	Boostrom SY, Grant CS, Thompson GB, et al. Need for a revised staging consensus in medullary thyroid carcinoma. Arch Surg, 2009, 144(7): 663-669.
58.	Pena L, Clayman GL, Grubbs EG, et al. Management of the lateral neck compartment in patients with sporadic medullary thyroid cancer. Head Neck, 2018, 40(1): 79-85.
59.	Spanheimer PM, Ganly I, Chou JF, et al. Prophylactic lateral neck dissection for medullary thyroid carcinoma is not associated with improved survival. Ann Surg Oncol, 2021, 28(11): 6572-6579.
60.	van Beek DJ, Almquist M, Bergenfelz AO, et al. Complications after medullary thyroid carcinoma surgery: multicentre study of the SQRTPA and EUROCRINE^® databases. Br J Surg, 2021, 108(6): 691-701.

1. Szabo Yamashita T, Rogers RT, Foster TR, et al. Medullary thyroid cancer: What is the optimal management of the lateral neck in a node negative patient at index operation?. Surgery, 2022, 171(1): 177-181.
2. Cabanillas ME, McFadden DG, Durante C. Thyroid cancer. Lancet, 2016, 388(10061): 2783-2795.
3. Wells SA, Asa SL, Dralle H, et al. Revised American Thyroid Association guidelines for the management of medullary thyroid carcinoma. Thyroid, 2015, 25(6): 567-610.
4. Haddad RI, Bischoff L, Ball D, et al. Thyroid carcinoma, version 2.2022, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2022, 20(8): 925-951.
5. Filetti S, Durante C, Hartl D, et al. Thyroid cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2019, 30(12): 1856-1883.
6. Saltiki K, Simeakis G, Karapanou O, et al. Management of endocrine disease: medullary thyroid cancer: from molecular biology and therapeutic pitfalls to future targeted treatment perspectives. Eur J Endocrinol, 2022, 187(3): R53-R63. doi: 10.1530/EJE-22-0312.
7. Kaliszewski K, Ludwig M, Ludwig B, et al. Update on the diagnosis and management of medullary thyroid cancer: What has changed in recent years? Cancers (Basel), 2022, 14(15): 3643. doi: 10.3390/cancers14153643.
8. Jayasinghe R, Basnayake O, Jayarajah U, et al. Management of medullary carcinoma of the thyroid: a review. J Int Med Res, 2022, 50(7): 3000605221110698. doi:10.1177/03000605221110698.
9. Fugazzola L. Medullary thyroid cancer—An update. Best Pract Res Clin Endocrinol Metab, 2023, 37(1): 101655.
10. Baloch ZW, Asa SL, Barletta JA, et al. Overview of the 2022 WHO classification of thyroid neoplasms. Endocr Pathol, 2022, 33(1): 27-63.
11. Kim M, Kim BH. Current guidelines for management of medullary thyroid carcinoma. Endocrinol Metab (Seoul), 2021, 36(3): 514-524.
12. Frisco NA, Gunn AH, Wang F, et al. Guideline adherence and practice patterns in the management of medullary thyroid cancer. J Surg Res, 2023, 281: 214-222.
13. Fritz C, De Ravin E, Suresh N, et al. Clinical practice guidelines for management of medullary thyroid carcinoma: An AGREEⅡ appraisal. Am J Otolaryngol, 2022, 43(6): 103606.
14. Machens A, Hauptmann S, Dralle H. Increased risk of lymph node metastasis in multifocal hereditary and sporadic medullary thyroid cancer. World J Surg, 2007, 31(10): 1960-1965.
15. Machens A, Schneyer U, Holzhausen HJ, et al. Prospects of remission in medullary thyroid carcinoma according to basal calcitonin level. J Clin Endocrinol Metab, 2005, 90(4): 2029-2034.
16. Fialkowski EA, Moley JF. Current approaches to medullary thyroid carcinoma, sporadic and familial. J Surg Oncol, 2006, 94(8): 737-747.
17. Park JH, Lee YS, Kim BW, et al. Skip lateral neck node metastases in papillary thyroid carcinoma. World J Surg, 2012, 36(4): 743-747.
18. Brammen L, Niederle MB, Riss P, et al. Medullary thyroid carcinoma: Do ultrasonography and F-DOPA-PET-CT influence the initial surgical strategy? Ann Surg Oncol, 2018, 25(13): 3919-3927.
19. Kushchayev SV, Kushchayeva YS, Tella SH, et al. Medullary thyroid carcinoma: An update on imaging. J Thyroid Res, 2019, 2019: 1893047.
20. Traylor KS. Computed tomography and MR imaging of thyroid disease. Radiol Clin North Am, 2020, 58(6): 1059-1070.
21. Marques B, Cunha N, Martins RG, et al. Lymph node metastases of medullary thyroid cancer: role of calcitonin in the washout fluid of fine-needle aspiration. Int J Endocrinol, 2020, 2020: 9267972.
22. Ciarletto AM, Narick C, Malchoff CD, et al. Analytical and clinical validation of pairwise microRNA expression analysis to identify medullary thyroid cancer in thyroid fine-needle aspiration samples. Cancer Cytopathol, 2021, 129(3): 239-249.
23. Riddle ND, Bui MM. Fibrous dysplasia. Arch Pathol Lab Med, 2013, 137(1): 134-138.
24. Klain M, Hadoux J, Nappi C, et al. Imaging medullary thyroid cancer patients with detectable serum markers: state of the art and future perspectives. Endocrine, 2022, 75(2): 330-337.
25. Giovanella L, Treglia G, Iakovou I, et al. EANM practice guideline for PET/CT imaging in medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging, 2020, 47(1): 61-77.
26. Castinetti F, Taïeb D. Positron emission tomography imaging in medullary thyroid carcinoma: time for reappraisal? Thyroid, 2021, 31(2): 151-155.
27. Treglia G, Sadeghi R, Giovinazzo F, et al. PET with different radiopharmaceuticals in neuroendocrine neoplasms: An umbrella review of published meta-analyses. Cancers (Basel), 2021, 13(20): 5172.
28. Sesti A, Mayerhoefer M, Weber M, et al. Relevance of calcitonin cut-off in the follow-up of medullary thyroid carcinoma for conventional imaging and 18-fluorine-fluorodihydroxyphenylalanine PET. Anticancer Res, 2014, 34(11): 6647-6654.
29. Romero-Lluch AR, Cuenca-Cuenca JI, Guerrero-Vázquez R, et al. Diagnostic utility of PET/CT with ¹⁸F-DOPA and ¹⁸F-FDG in persistent or recurrent medullary thyroid carcinoma: the importance of calcitonin and carcinoembryonic antigen cutoff. Eur J Nucl Med Mol Imaging, 2017, 44(12): 2004-2013.
30. Treglia G, Castaldi P, Villani MF, et al. Comparison of ¹⁸F-DOPA, ¹⁸F-FDG and ⁶⁸Ga-somatostatin analogue PET/CT in patients with recurrent medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging, 2012, 39(4): 569-580.
31. Ong SC, Schöder H, Patel SG, et al. Diagnostic accuracy of ¹⁸F-FDG PET in restaging patients with medullary thyroid carcinoma and elevated calcitonin levels. J Nucl Med, 2007, 48(4): 501-507.
32. Castroneves LA, Coura Filho G, de Freitas RMC, et al. Comparison of ⁶⁸Ga PET/CT to other imaging studies in medullary thyroid cancer: superiority in detecting bone metastases. J Clin Endocrinol Metab, 2018, 103(9): 3250-3259.
33. Bodet-Milin C, Faivre-Chauvet A, Carlier T, et al. Anti-CEA pretargeted immuno-PET shows higher sensitivity than DOPA PET/CT in detecting relapsing metastatic medullary thyroid carcinoma: Post hoc analysis of the iPET-MTC study. J Nucl Med, 2021, 62(9): 1221-1227.
34. Machens A, Hauptmann S, Dralle H. Prediction of lateral lymph node metastases in medullary thyroid cancer. Br J Surg, 2008, 95(5): 586-591.
35. Machens A, Dralle H. Biomarker-based risk stratification for previously untreated medullary thyroid cancer. J Clin Endocrinol Metab, 2010, 95(6): 2655-2663.
36. Dackiw AP. The surgical management of medullary thyroid cancer. Otolaryngol Clin North Am, 2010, 43(2): 365-374.
37. Green K, Hintze J, O’Neill JP. Surgical aspects and controversies in the management of medullary thyroid cancer. Ir J Med Sci, 2022, 191(6): 2461-2466.
38. Ito Y, Onoda N, Okamoto T. The revised clinical practice guidelines on the management of thyroid tumors by the Japan Associations of Endocrine Surgeons: Core questions and recommendations for treatments of thyroid cancer. Endocr J, 2020, 67(7): 669-717.
39. Asarkar A, Chang BA, Nathan CO. What is the extent of neck dissection in medullary thyroid carcinoma? Laryngoscope, 2021, 131(3): 458-459.
40. Viola D, Elisei R. Management of medullary thyroid cancer. Endocrinol Metab Clin North Am, 2019, 48(1): 285-301.
41. Pavlidis E, Sapalidis K, Chatzinikolaou F, et al. Medullary thyroid cancer: molecular factors, management and treatment. Rom J Morphol Embryol, 2020, 61(3): 681-686.
42. Mitchell AL, Gandhi A, Scott-Coombes D, et al. Management of thyroid cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol, 2016, 130(S2): S150-S160. doi: 10.1017/S0022215116000578.
43. 中国医师协会外科医师分会甲状腺外科医师委员会, 中国抗癌协会甲状腺癌专业委员会, 中国研究型医院学会甲状腺疾病专业委员会. 甲状腺髓样癌诊断与治疗中国专家共识(2020版). 中国实用外科杂志, 2020, 40(9): 1012-1020.
44. Bowen A, Mani N, Penney S, et al. Surgical management of medullary thyroid cancer: which guidelines should we follow?. J Laryngol Otol, 2015, 129(5): 478-483.
45. Stamatakos M, Paraskeva P, Katsaronis P, et al. Surgical approach to the management of medullary thyroid cancer: when is lymph node dissection needed?. Oncology, 2013, 84(6): 350-355.
46. Ahn HS, Kim DW, Lee YJ, et al. Postoperative neck ultraso-nography surveillance after thyroidectomy in patients with medullary thyroid carcinoma: A multicenter study. Front Endocrinol (Lausanne), 2018, 9: 102.
47. Zhou TH, Zhao LQ, Zhang Y, et al. The prediction of metastases of lateral cervical lymph node in medullary thyroid carcinoma. Front Endocrinol (Lausanne), 2021, 12: 741289.
48. Jin L, Zhang X, Ni S, et al. A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer. Front Endocrinol (Lausanne), 2022, 13: 902546.
49. Kaserer K, Scheuba C, Neuhold N, et al. Sporadic versus familial medullary thyroid microcarcinoma: a histopathologic study of 50 consecutive patients. Am J Surg Pathol, 2001, 25(10): 1245-1251.
50. Niederle MB, Riss P, Selberherr A, et al. Omission of lateral lymph node dissection in medullary thyroid cancer without a desmoplastic stromal reaction. Br J Surg, 2021, 108(2): 174-181.
51. Opsahl EM, Akslen LA, Schlichting E, et al. The role of calcitonin in predicting the extent of surgery in medullary thyroid carcinoma: A nationwide population-based study in Norway. Eur Thyroid J, 2019, 8(3): 159-166.
52. Modigliani E, Cohen R, Campos JM, et al. Prognostic factors for survival and for biochemical cure in medullary thyroid carcinoma: results in 899 patients. The GETC Study Group. Groupe d'étude des tumeurs à calcitonine. Clin Endocrinol (Oxf), 1998, 48(3): 265-273.
53. Lindsey SC, Ganly I, Palmer F, et al. Response to initial therapy predicts clinical outcomes in medullary thyroid cancer. Thyroid, 2015, 25(2): 242-249.
54. Franc S, Niccoli-Sire P, Cohen R, et al. Complete surgical lymph node resection does not prevent authentic recurrences of medullary thyroid carcinoma. Clin Endocrinol (Oxf), 2001, 55(3): 403-409.
55. Ahn SH, Chung EJ. Significance of neck dissection for the treatment of clinically-evident medullary thyroid carcinomas: A systematic review. Auris Nasus Larynx, 2019, 46(3): 417-423.
56. Tuttle RM, Ganly I. Risk stratification in medullary thyroid cancer: moving beyond static anatomic staging. Oral Oncol, 2013, 49(7): 695-701.
57. Boostrom SY, Grant CS, Thompson GB, et al. Need for a revised staging consensus in medullary thyroid carcinoma. Arch Surg, 2009, 144(7): 663-669.
58. Pena L, Clayman GL, Grubbs EG, et al. Management of the lateral neck compartment in patients with sporadic medullary thyroid cancer. Head Neck, 2018, 40(1): 79-85.
59. Spanheimer PM, Ganly I, Chou JF, et al. Prophylactic lateral neck dissection for medullary thyroid carcinoma is not associated with improved survival. Ann Surg Oncol, 2021, 28(11): 6572-6579.
60. van Beek DJ, Almquist M, Bergenfelz AO, et al. Complications after medullary thyroid carcinoma surgery: multicentre study of the SQRTPA and EUROCRINE^® databases. Br J Surg, 2021, 108(6): 691-701.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Progress in diagnosis and treatment of lateral cervical lymph node dissection in medullary thyroid carcinoma

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