Treatment of medullary thyroid carcinoma: an update

Prognosis and treatment effectiveness of medullary thyroid carcinoma (MTC) are largely related to the tumour stage, so that early diagnosis represents an important goal for the management of patients. Recent advances in genet ic testing have improved the clinical approach to the familial MTC syndrome s. There is general agreement that the primary operation for MTC should obt ain the complete removal of the neoplastic tissue in the neck, because any adjuvant treatment has never been proven to be effective. The management of residual/recurrent or metastatic MTC still remains controversial, although a multimodal approach to advanced disease may be of value in palliation or local control of tumour progression. The role of surgery, external radioth erapy, radionuclide therapy and medical treatment, including biological res ponse modifiers and cytotoxic drugs, are reviewed and discussed.