• Login
    JavaScript is disabled for your browser. Some features of this site may not work without it.
    Prophylactic thyroidectomy in children with multiple endocrine neoplasia type 2 
    •   QMRO Home
    • William Harvey Research Institute
    • Centre for Endocrinology
    • Prophylactic thyroidectomy in children with multiple endocrine neoplasia type 2
    •   QMRO Home
    • William Harvey Research Institute
    • Centre for Endocrinology
    • Prophylactic thyroidectomy in children with multiple endocrine neoplasia type 2
    ‌
    ‌

    Browse

    All of QMROCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects
    ‌
    ‌

    Administrators only

    Login
    ‌
    ‌

    Statistics

    Most Popular ItemsStatistics by CountryMost Popular Authors

    Prophylactic thyroidectomy in children with multiple endocrine neoplasia type 2

    View/Open
    Accepted version (54.96Kb)
    Volume
    105
    Pagination
    1319 - 1327
    DOI
    10.1002/bjs.10856
    Journal
    British Journal of Surgery
    Issue
    10
    ISSN
    0007-1323
    Metadata
    Show full item record
    Abstract
    © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd Background: In patients with multiple endocrine neoplasia type 2 (MEN2) syndrome, genetic testing offers early diagnosis, stratifies the risk of developing medullary thyroid cancer (MTC) and informs the timing of thyroidectomy. The efficacy of treatment, which depends on timely and safe surgery, is not well established. Methods: This was a retrospective review of diagnostic and clinicopathological outcomes of prophylactic thyroidectomy in children with MEN2 between 1995 and 2013 in the UK. American Thyroid Association (ATA) 2009 guidelines were used as a benchmark for adequate treatment. Results: Seventy-nine children from 16 centres underwent total thyroidectomy. Thirty-eight patients (48 per cent) underwent genetic testing and 36 (46 per cent) had an operation performed above the age recommended by the ATA 2009 guidelines; pathology showed MTC in 30 patients (38 per cent). Late surgery, above-normal preoperative calcitonin level and MTC on pathology correlated with late genetic testing. Twenty-five children had lymphadenectomy; these patients had more parathyroid glands excised (mean difference 0·61, 95 per cent c.i. 0·24 to 0·98; P = 0·001), and were more likely to have hypocalcaemia requiring medication (relative risk (RR) 3·12, 95 per cent c.i. 1·54 to 6·32; P = 0·002) and permanent hypoparathyroidism (RR 3·24, 1·29 to 8·11; P = 0·010) compared with those who underwent total thyroidectomy alone. Age did not influence the development of complications. Conclusion: Late genetic testing may preclude age-appropriate surgery, increasing the risk of operating when MTC has already developed. Early genetic testing and age-appropriate surgery may help avoid unnecessary lymphadenectomy and improve outcomes.
    Authors
    Prete, FP; Abdel-Aziz, T; Morkane, C; Brain, C; Kurzawinski, TR; Hindmarsh, P; Dattani, M; Spoudeas, H; Amin, R; Watkinson, J
    URI
    http://qmro.qmul.ac.uk/xmlui/handle/123456789/53286
    Collections
    • Centre for Endocrinology [341]
    Licence information
    This is the peer reviewed version of the following article: Prete FP, Abdel‐Aziz T, Morkane C, Brain C, Kurzawinski TR, MEN2 in Children UK Collaborative Group, Hindmarsh P, Dattani M, Spoudeas H, Amin R, Watkinson J. Prophylactic thyroidectomy in children with multiple endocrine neoplasia type 2. British Journal of Surgery. 2018 Apr 17., which has been published in final form at https://doi.org/10.1002/bjs.10856. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
    Copyright statements
    © 2018 BJS Society Ltd Published by John Wiley & Sons Ltd
    Twitter iconFollow QMUL on Twitter
    Twitter iconFollow QM Research
    Online on twitter
    Facebook iconLike us on Facebook
    • Site Map
    • Privacy and cookies
    • Disclaimer
    • Accessibility
    • Contacts
    • Intranet
    • Current students

    Modern Slavery Statement

    Queen Mary University of London
    Mile End Road
    London E1 4NS
    Tel: +44 (0)20 7882 5555

    © Queen Mary University of London.