THE VALUE OF LYMPH-NODE DISSECTION IN HEREDITARY MEDULLARY-THYROID CARCINOMA - A RETROSPECTIVE, EUROPEAN, MULTICENTER STUDY

Clinical data of 139 patients with hereditary medullary thyroid carcin oma (HMTC) from nine european centres surgically treated from 1980 to 1991 were reviewed retrospectively to analyse the value of systematic versus selective lymphadenectomy (LA). Biochemical cure rate was signi ficantly higher in patients who underwent LA compared to patients who did not. In nodal-positive HMTC, systematic LA compared to selective L A improved biochemical cure in small but not large tumours. In nodal-n egative HMTC, systematic LA compared to selective LA could not improve biochemical cure in either small or large primary tumours. To prevent local recurrences with the risk of increased surgical and tumour-rela ted morbidity, systematic LA should be performed in all HMTC patients regardless of the primary tumour stage. However, an improvement of bio chemical cure by systematic LA seems to be possible only in nodal-posi tive small primary tumours without distant metastases.