Surgical management of medullary thyroid cancer: which guidelines should we follow?

Background/Purpose: Surgery is the only effective primary treatment for medullary thyroid cancer (MTC). American Thyroid Association (ATA) and British Thyroid Association (BTA) guidelines offer differing surgical strategies. Which guidelines should we follow? Methods: Retrospective analysis of the surgical management of 41 patients with sporadic MTC, compared to current guidelines. Biochemical cure assessed with first post-operative calcitonin, timing variable, patterns examined to ensure validity. Results: Thirty eight patients (95%) had primary surgery with curative intent. All had total thyroidectomy, lymph node dissection was variable. ATA guidance followed most frequently. An association between stage of disease and biochemical cure observed (p<0.001).