The surgical treatment of medullary thyroid carcinoma

Medullary thyroid carcinoma (MTC) is a unique disease in solid tumor oncolo gy due to its ability to secrete calcitonin (iCT), a highly sensitive and s pecific serum marker of persistent or recurrent disease even at a microscop ic level. The relatively long duration of survival experienced by most pati ents with MTC combined with the visible nature of surgical complications, w hen they occur, has caused most surgeons to take a conservative approach to the operative management and follow-up of patients with MTC. In contrast, the patient, family physician, and endocrinologist watch the iCT slowly ris e, indicative of persistent and usually progressive invasive cancer. Amidst this clinical dilemma, we developed a standardized diagnostic and operativ e strategy to maximize local-regional tumor control and facilitate patient management. (C) 1999 Wiley-Liss, Inc.