{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:50:14Z","timestamp":1788349814015,"version":"build-2803163510"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2023,8,26]],"date-time":"2023-08-26T00:00:00Z","timestamp":1693008000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,12,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There remains uncertainty regarding the optimal extent of initial surgery and management of recurrent disease in medullary thyroid cancer (MTC). We aim to describe the patterns of disease recurrence and outcomes of the reoperative surgery in a cohort of consecutively treated patients at a specialized tertiary referral center.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study of 235 surgically treated patients with MTC at a tertiary referral center was performed using prospectively collected data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the study period 1986-2022, 235 patients underwent surgery for MTC. Of these, 45 (19%) patients had reoperative surgery for cervical nodal recurrence at a median (range) 2.1 (0.3-16) years following the index procedure. After a median follow-up of 4 years, 38 (84%) patients remain free of structural cervical recurrence, although 15 (33%) underwent 2 or more reoperative procedures. No long-term complications occurred after reoperative surgery. Local cervical recurrence was independently predicted by pathologically involved nodal status (OR 5.10, P\u2005=\u2005.01) and failure to achieve biochemical cure (OR 5.0, P\u2005=\u2005.009). Local recurrence did not adversely affect overall survival and was not associated with distant recurrence (HR 0.93, P\u2005=\u2005.83). Overall survival was independently predicted by high pathological grade (HR 10.0, P\u2005=\u2005.002) and the presence of metastatic disease at presentation (HR 8.27, P\u2005=\u20050018).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Loco-regional recurrence in MTC does not impact overall survival, or the development of metastatic disease, demonstrating the safety of the staged approach to the clinically node-negative lateral neck. When recurrent disease is technically resectable, reoperative surgery can be undertaken with minimal morbidity in a specialized center and facilitates structural disease control.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyad232","type":"journal-article","created":{"date-parts":[[2023,7,29]],"date-time":"2023-07-29T00:35:58Z","timestamp":1690590958000},"page":"1064-1071","source":"Crossref","is-referenced-by-count":23,"title":["Management of Medullary Thyroid Cancer: Patterns of Recurrence and Outcomes of Reoperative Surgery"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4634-5963","authenticated-orcid":false,"given":"Alexander J","family":"Papachristos","sequence":"first","affiliation":[{"name":"Department of Endocrine Surgery, Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District , Sydney, NSW , Australia"},{"name":"Department of Surgery, Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6206-2480","authenticated-orcid":false,"given":"Laura E","family":"Nicholls","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Mechera","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad M","family":"Aniss","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District , Sydney, NSW , Australia"},{"name":"Department of Surgery, Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Robinson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney , Sydney, NSW , Australia"},{"name":"Department of Endocrinology, Royal North Shore Hospital , Sydney, NSW , Australia"},{"name":"Department of Cancer Diagnosis and Pathology, Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roderick","family":"Clifton-Bligh","sequence":"additional","affiliation":[{"name":"Department of Surgery, Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney , Sydney, NSW , Australia"},{"name":"Department of Endocrinology, Royal North Shore Hospital , Sydney, NSW , Australia"},{"name":"Department of Cancer Diagnosis and Pathology, Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony J","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Surgery, Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney , Sydney, NSW , Australia"},{"name":"Department of Anatomical Pathology, NSW Health Pathology, Royal North Shore Hospital , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Learoyd","sequence":"additional","affiliation":[{"name":"GenesisCare North Shore Health Hub Tower A , NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stan B","family":"Sidhu","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District , Sydney, NSW , Australia"},{"name":"Department of Surgery, Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Glover","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District , Sydney, NSW , Australia"},{"name":"Department of Surgery, Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney , Sydney, NSW , Australia"},{"name":"Department of Cancer Research, The Kinghorn Cancer Centre, Garvan Institute of Medical Research, St. Vincent\u2019s Clinical School, Faculty of Medicine, University of New South Wales , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh","family":"Delbridge","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Sywak","sequence":"additional","affiliation":[{"name":"Department of Endocrine Surgery, Endocrine Surgical Unit, Royal North Shore Hospital, Northern Sydney Local Health District , Sydney, NSW , Australia"},{"name":"Department of Surgery, Northern Clinical School, Sydney Medical School, Faculty of Medicine and Health, University of Sydney , Sydney, NSW , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,26]]},"reference":[{"key":"2023122612584759100_CIT0001","first-page":"35","article-title":"Genomics and epigenomics of medullary thyroid carcinoma: From sporadic disease to familial manifestations","volume-title":"Endocr Pathol.","author":"Barletta","year":"2021"},{"key":"2023122612584759100_CIT0002","first-page":"22","article-title":"Pattern of nodal metastasis for primary and reoperative thyroid cancer","volume-title":"World J Surg","author":"Machens","year":"2002"},{"key":"2023122612584759100_CIT0003","first-page":"549","article-title":"Medullary thyroid carcinoma: management of lymph node metastases","volume-title":"J Natl Compr Canc Netw","author":"Moley","year":"2010"},{"key":"2023122612584759100_CIT0004","first-page":"737","article-title":"Current approaches to medullary thyroid carcinoma, sporadic and familial","volume-title":"J Surg 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