Long-term course of patients with persistent hypercalcitoninemia after apparent curative primary surgery for medullary thyroid carcinoma

Ann Surg. 1990 Oct;212(4):395-400; discussion 400-1. doi: 10.1097/00000658-199010000-00002.


Thirty-one patients with persistent hypercalcitoninemia after seemingly adequate primary operation for medullary thyroid carcinoma (MTC) were followed for a mean period of 11.9 years after operation. Ten patients had sporadic MTC and the remaining patients were members of families with multiple endocrine neoplasia (MEN)--either MEN 2A (15 patients) or MEN 2B (six patients). Overall 5- and 10-year survival rates were 90% and 86%, respectively. Only four patients died at the completion of the study: two of MTC and two of unrelated causes. Eleven patients (35.5%) underwent surgical re-exploration after demonstration of recurrent disease clinically or radiologically. In no patient did the calcitonin level return to normal after re-exploration. The presence of more than three metastatic nodes at the time of initial operation was a statistically significant (p = 0.003) predictor for disease recurrence. Factors approaching statistical significance were patients younger than age 35 (p = 0.06) and the percentage of cells in the S phase of cell division (0.07). This data supports a conservative surgical philosophy in the management of the patient with persistent hypercalcitoninemia after resection of MTC.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Calcitonin / blood*
  • Carcinoma / blood*
  • Carcinoma / genetics
  • Carcinoma / mortality
  • Carcinoma / surgery*
  • Child
  • DNA, Neoplasm / analysis
  • Follow-Up Studies
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Ploidies
  • Postoperative Period
  • Recurrence
  • Reoperation
  • Survival Rate
  • Thyroid Neoplasms / blood*
  • Thyroid Neoplasms / genetics
  • Thyroid Neoplasms / mortality
  • Thyroid Neoplasms / surgery*


  • DNA, Neoplasm
  • Calcitonin