J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 3360KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 88(1): 102-108, 1987

Original article

ASSESSMENT OF SURGICAL TREATMENTS FOR MEDULLARY THYROID CARCINOMA BY ANALYSIS OF SERUM CALCITONIN LEVELS

Second Department of Surgery, Kagawa Medical School, Kagawa, Japan
*) Kuma Hospital, Kobe, Japan
**) Second Department of Surgery, Osaka University Medical School, Osaka, Japan

Akira Miyauchi, Fumio Matsuzuka*), Kanji Kuma*), Shin-ichiro Takai**), Masazumi Maeda

In 67 patients with medullary thyroid carcinoma, serum calcitonin levels were measured before (S1) and after (S2) surgical therapy. Doubling time of serum calcitonin levels (T2) was calculated in each patient with elevated calcitonin levels after surgery. Residual tumor weight (W2) was estimated as W1 S2/ (S1S2) where W1 was resected tumor weight. Reduction index (α) is defined as S2/S1＝(1/2)α. αT2 indicates expected prolongation in survival (EPS) by surgical therapy. Expected duration of survival after surgery (EDS) is estimated as βT2, where β times of doubling of the residual tumor (W2) make 1000g of tumor which would generally kill the host.
Death within 3 years after surgery or recurrence within 5 years was best associated with short EPS followed by short T2 or smallα. Postoperative calcitonin levels had a rather weak correlation with the prognosis, and preoperative calcitonin levels had almost no correlation with the prognosis during the present observation period. All 3 patients with EDS shorter than 3.9 years died within 2 years and 2 months after surgery.
These parameters allow quantitative judgement of the surgical benefit and quantitative prediction of the prognosis in each individual patient.

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