Evidence map›Paper›PMID 27604949›Full record

ArticleThyroid : official journal of the American Thyroid Association2016

Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study.

Garth F Essig, Kyle Porter, David Schneider, Debora Arpaia, Susan C Lindsey, Giulia Busonero, Daniel Fineberg, Barbara Fruci, Kristien Boelaert, Johannes W Smit and 12 more

Open access · greenAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Thyroid : official journal of the American Thyroid Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
3.5field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 58 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Is hemithyroidectomy enough? Low risk of occult contralateral disease in sporadic medullary thyroid cancer.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
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  17. Management of medullary carcinoma of the thyroid: a review.The Journal of international medical research · 2022
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  20. [Extent of resection in intrathyroidal medullary thyroid cancer].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2020
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors at 8 institutions in 5 countries.

Garth F Essig1 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center , Columbus, Ohio.
Kyle Porter2 Center for Biostatistics, The Ohio State University Wexner Medical Center , Columbus, Ohio.
David Schneider3 Section of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.
Debora Arpaia4 Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples, Italy .
Susan C Lindsey5 Division of Endocrinology, Laboratory of Molecular and Translational Endocrinology, Department of Medicine, Federal University of Sao Paulo , São Paulo, Brazil .
Giulia Busonero6 Section of Endocrinology and Metabolism, Department of Medical, Surgical, and Neurological Sciences, University of Siena , Siena, Italy .
Daniel Fineberg7 Department of Endocrinology and Diabetes, Alfred Health, Monash University , Melbourne, Australia .
Barbara Fruci8 Département of Endocrinology and Nephrology, Pierre Oudot Hospital , Bourgoin-Jallieu, France .
Kristien Boelaert9 School of Clinical and Experimental Medicine, Centre for Endocrinology, Diabetes, and Metabolism, Institute of Biomedical Research, University of Birmingham , Birmingham, United Kingdom .
Johannes W Smit10 Department of Internal Medicine, Radboud University Medical Centre , Nijmegen, The Netherlands .
Johannes Arnoldus Anthonius Meijer11 Department of Internal Medicine, Albert Schweitzer Hospital , Dordrecht, The Netherlands .
Leonidas H Duntas12 Evgenidion Hospital, Unit of Endocrinology, Diabetes and Metabolism, Thyroid Section, University of Athens , Athens, Greece .
Neil Sharma13 Institute of Head and Neck Studies and Education, University of Birmingham , Birmingham, United Kingdom .
Giuseppe Costante14 Department of Medicine, Institut Jules Bordet , Brussels, Belgium .
Sebastiano Filetti15 Dipartimento Di Medicina Interna, University of Roma La Sapienza , Rome, Italy .
Rebecca S Sippel3 Section of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.
Bernadette Biondi4 Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples, Italy .
Duncan J Topliss7 Department of Endocrinology and Diabetes, Alfred Health, Monash University , Melbourne, Australia .
Furio Pacini6 Section of Endocrinology and Metabolism, Department of Medical, Surgical, and Neurological Sciences, University of Siena , Siena, Italy .
Rui M B Maciel5 Division of Endocrinology, Laboratory of Molecular and Translational Endocrinology, Department of Medicine, Federal University of Sao Paulo , São Paulo, Brazil .
Patrick C Walz1 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center , Columbus, Ohio.
Richard T Kloos16 Veracyte, Inc. , South San Francisco, California.
The Ohio State University Wexner Medical Center · USUniversity of Naples Federico II · ITUniversity of Wisconsin–Madison · USAlbert Schweitzer Ziekenhuis · NLInstitut Jules Bordet · BERadboud University Nijmegen · NLUniversity of Birmingham · GBVeracyte (United States) · US

Funding

The Ohio State University and MD Anderson Cancer Center Thyroid Cancer SPOREP50CA168505 · NCI · OHIO STATE UNIVERSITY · PI KIRSCHNER, LAWRENCE S · 2013 to 2017
$10.9M
Medical Research Council G0601811Medical Research Council MR/J001414/1NCI NIH HHS P50 CA168505
6 · The paper itself

Abstract

backgroundCurrent surgical standard of care in sporadic medullary thyroid carcinoma (sMTC) consists of a minimum of total thyroidectomy with central neck dissection. Some have suggested thyroid lobectomy with isthmusectomy and central neck dissection for patients with sMTC, given their lower frequency of bilateral disease, although this topic has not been thoroughly studied. This study assessed the prevalence of multifocality in sMTC via a large international multi-institutional retrospective review to quantify this prevalence, including the impact of geography, to assess more accurately the risks associated with alternative surgical approaches.

methodsA retrospective chart review of sMTC patients from 11 institutions over 29 years (1983-2011) was undertaken. Data regarding focality, extent of disease, RET germline analysis plus family and clinical history for multiple endocrine neoplasia type 2 (MEN2), and demographic data were collected and analyzed.

resultsPatients from four continents and seven countries were included in the sample. Data for 313 patients with documented sMTC were collected. Of these, 81.2% were confirmed with negative RET germline testing, while the remaining 18.8% demonstrated a negative family history and no manifestations of MEN2 syndromes other than MTC. Bilateral disease was identified in 17/306 (5.6%) patients, while multifocal disease was noted in 50/312 (16.0%) sMTC patients. When only accounting for germline negative patients, these rates were not significantly different (5.6% and 17%, respectively). Among them, when disease was unifocal in the ipsilateral lobe and isthmus, bilateral disease was present in 6/212 (2.8%) cases. When disease was multifocal in the ipsilateral lobe or isthmus, then bilateral disease was present in 8/37 (21.6%) cases (p < 0.001). No geographic differences in focality were identified.

conclusionsThe 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard of care for initial surgery, as less complete thyroid surgery may fail to address fully the primary site of disease. Whether ipsilateral tumor focality should be an independent factor determining the need for completion thyroidectomy when sMTC is diagnosed after hemithyroidectomy remains to be determined.

Indexed as

AdultAgedAged, 80 and overBiopsyCarcinoma, MedullaryCarcinoma, NeuroendocrineCohort StudiesHumansMiddle AgedNeoplasm Recurrence, LocalNeoplasm StagingPractice Guidelines as TopicPrevalenceRetrospective StudiesThyroidectomyThyroid Glandhumansmedullary thyroid carcinomamultifocalitysurgerythyroid neoplasm

Identifiers

PMID27604949
PMCPMC6453487
OpenAlexW2507625448

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.