caa a22 4500 475803736 CHVBK 20180406123744.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s002680010226 doi (NATIONALLICENCE)springer-10.1007/s002680010226 Unilateral Surgery Supported by Germline RET Oncogene Mutation Analysis in Patients with Sporadic Medullary Thyroid Carcinoma [Elektronische Daten] [Akira Miyauchi, Fumio Matsuzuka, Keisuke Hirai, Tomotsu Yokozawa, Kaoru Kobayashi, Seiji Kuma, Kanji Kuma, Hitoyasu Futami, Ken Yamaguchi] Compared to hereditary medullary thyroid carcinoma (MTC), sporadic MTC tends to be unicentric and confined to one lobe. Patients with sporadic MTC usually undergo total thyroidectomy because of a possible hereditary or bilateral process. We evaluated the usefulness of germline RET oncogene mutation analysis in surgery for apparently sporadic MTC and performed unilateral surgery on patients without detectable mutation. In 36 patients with a preoperative diagnosis of apparently sporadic MTC, we performed germline RET oncogene mutation analyses: before surgery in 8 recent patients and after surgery in 28 who had been treated before 1996. Of the latter, 5 had bilateral MTC. DNA samples were extracted from their peripheral blood, and the polymerase chain reaction products of the RET proto-oncogene were analyzed using single-strand conformation polymorphism analysis and the direct sequencing methods. Before 1996 we often performed total thyroidectomy but changed to hemithyroidectomy thereafter, except in one patient with associated Graves' ophthalmopathy. Our minimal standard practice included systematic central and ipsilateral neck dissection. The outcome was assessed in terms of gastrin- and calcium-stimulated plasma calcitonin levels. Germline RET mutations were found in six patients. Five of these patients had bilateral MTC, whereas all 30 patients without mutation had unilateral disease. Hemithyroidectomy in seven of our recent patients resulted in normalization of plasma calcitonin levels in all, although four were found to have microscopic lymph node involvement. In conclusion, hemithyroidectomy with systematic central and ipsilateral neck dissection is an appropriate procedure for patients with sporadic MTC without detectable germline RET mutations. Société Internationale de Chirurgie, 2000 Miyauchi Akira Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut Matsuzuka Fumio Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut Hirai Keisuke Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut Yokozawa Tomotsu Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut Kobayashi Kaoru Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut Kuma Seiji Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut Kuma Kanji Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut Futami Hitoyasu Growth Factor Division, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan, JP aut Yamaguchi Ken Growth Factor Division, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan, JP aut World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1367-1372 0364-2313 24:11<1367 2000 24 268 https://doi.org/10.1007/s002680010226 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002680010226 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Miyauchi Akira Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut NATIONALLICENCE 700 1- Matsuzuka Fumio Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut NATIONALLICENCE 700 1- Hirai Keisuke Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut NATIONALLICENCE 700 1- Yokozawa Tomotsu Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut NATIONALLICENCE 700 1- Kobayashi Kaoru Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut NATIONALLICENCE 700 1- Kuma Seiji Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut NATIONALLICENCE 700 1- Kuma Kanji Kuma Hospital, 8-2-35 Shimoyamate-dori, Chuo-ku, Kobe 650-0011, Japan, JP aut NATIONALLICENCE 700 1- Futami Hitoyasu Growth Factor Division, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan, JP aut NATIONALLICENCE 700 1- Yamaguchi Ken Growth Factor Division, National Cancer Center Research Institute, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan, JP aut NATIONALLICENCE 773 0- World Journal of Surgery Springer-Verlag 24/11(2000-11-01), 1367-1372 0364-2313 24:11<1367 2000 24 268 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer