Annals of Medical Research DOI: 10.5455/annalsmedres.2018.10.230 2019;26(1)86-90 Original Article Surgical therapy of medullary thyroid cancer and our clinical experiences Aydincan Akdur 1 , Hakan Yabanoglu 2 , Ilker Murat Arer 2 , Abdirahman Sakulen Hargura 2 , Nazim Emrah Kocer 3 , Tevfk Avci 1 1 Baskent University Faculty of Medicine, Department of General Surgery, Ankara, Turkey 2 Baskent University Adana Dr. Turgut Noyan Hospital, Department of General Surgery, Adana, Turkey 3 Baskent University Adana Dr. Turgut Noyan Hospital, Department of Pathology, Adana, Turkey Copyright © 2019 by authors and Annals of Medical Research Publishing Inc. Abstract Aim: Medullary thyroid cancer (MTC) is a rare neuroendocrine tumor that originates from the thyroid parafollicular C cells and produces calcitonin. It is a quite aggressive disease with a potential to cause serious morbidity and mortality. In this study we aimed to report treatment outcomes of MTC, which has a bad prognosis and is diffcult to manage. Material and Methods: The medical records of 1287 patients who were operated on for thyroid cancer between 2009 and 2018 were retrospectively assessed. Twenty-one patients (1.6%) were diagnosed with MTC. Results: Eleven (52.4%) patients were females. The age range of the patients was 54(14-85) years. Sixteen (76.2%) cases were sporadic and 5 (23.8%) were familial. Twelve patients underwent bilateral total thyroidectomy + central and unilateral neck dissection, 5(23.8%) bilateral total thyroidectomy + central and bilateral neck dissection, 4(19%) bilateral total thyroidectomy. Pathology examination revealed lymph node metastasis in 13(61.9%) patients. Three (14%) patients had simultaneous papillary thyroid cancer. Mean duration of follow-up was 52(3-96) months. Five (23.8%) patients suffered recurrence cervical lymph nodes (6 months later), lungs and bone metastasis (at 12th and 18th months), lungs (at 12thmonth), mediastinal lymph nodes (at 15th months), liver metastasis (at 6th months). Seven (33%) patients underwent chemo-radiotherapy. Conclusion: Surgery is the gold standard to control loco-regional disease and the only curative method among the available therapies in MTC treatment. Despite having a low incidence, MTC may still lead to serious mortality and morbidity in delayed cases and/or when loco-regional control cannot be achieved. Keywords: Medullary Thyroid Cancer; Surgery; Recurrence. Received: 25.10.2018 Accepted: 28.10.2018 Available online: 30.10.2018 Corresponding Author: Aydincan Akdur, Baskent University Faculty of Medicine, Department of General Surgery, Ankara, Turkey E-mail: aydinakdur@gmail.com 86 INTRODUCTION Medullary thyroid cancer (MTC) is a rare neuroendocrine tumor that originates from the thyroid parafollicular C cells and produces calcitonin (1). It was frst defned by Hazard in 1959 (2). The disease can be seen in hereditary and sporadic forms and constitutes 1-2% of all thyroid cancers (3). Its incidence has shown a rapid increase in the last two decades (4-6). MTC is unresponsive to radioactive iodine therapy and hormone suppression therapy and can be cured only by eliminating tumor and loco-regional metastases (1). In this study we aimed to report surgical treatment and outcomes of MTC, a diffcultto manage disease with poor prognosis. MATERIAL and METHODS We retrospectively reviewed the medical records of 1287 patients who were operated on for thyroid cancer at Başkent University General Surgery Clinic between 2009 and 2018. Twenty-one (1.6%) patients were diagnosed with MTC. The patients were evaluated with respect to age, sex, family history, physical examination, preoperative radiological examinations, calcitonin, CEA, calcium, fne needle aspiration biopsy (FNAB), operation type, complications, metastasis status, mortality, and follow- up duration. Statistical analysis: Data analysis was done with SPSS 23.0 software package. Categorical variables were expressed as number and percentage and continuous