Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study.
Identifieur interne : 001664 ( PubMed/Corpus ); précédent : 001663; suivant : 001665Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study.
Auteurs : Garth F. Essig ; Kyle Porter ; David Schneider ; Debora Arpaia ; Susan C. Lindsey ; Giulia Busonero ; Daniel Fineberg ; Barbara Fruci ; Kristien Boelaert ; Johannes W. Smit ; Johannes Arnoldus Anthonius Meijer ; Leonidas H. Duntas ; Neil Sharma ; Giuseppe Costante ; Sebastiano Filetti ; Rebecca S. Sippel ; Bernadette Biondi ; Duncan J. Topliss ; Furio Pacini ; Rui M B. Maciel ; Patrick C. Walz ; Richard T. KloosSource :
- Thyroid : official journal of the American Thyroid Association [ 1557-9077 ] ; 2016.
Abstract
Current 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.
DOI: 10.1089/thy.2016.0255
PubMed: 27604949
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Essig</name><affiliation><nlm:affiliation>1 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center , Columbus, Ohio.</nlm:affiliation></affiliation></author><author><name sortKey="Porter, Kyle" sort="Porter, Kyle" uniqKey="Porter K" first="Kyle" last="Porter">Kyle Porter</name><affiliation><nlm:affiliation>2 Center for Biostatistics, The Ohio State University Wexner Medical Center , Columbus, Ohio.</nlm:affiliation></affiliation></author><author><name sortKey="Schneider, David" sort="Schneider, David" uniqKey="Schneider D" first="David" last="Schneider">David Schneider</name><affiliation><nlm:affiliation>3 Section of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.</nlm:affiliation></affiliation></author><author><name sortKey="Arpaia, Debora" sort="Arpaia, Debora" uniqKey="Arpaia D" first="Debora" last="Arpaia">Debora Arpaia</name><affiliation><nlm:affiliation>4 Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples, Italy .</nlm:affiliation></affiliation></author><author><name sortKey="Lindsey, Susan C" sort="Lindsey, Susan C" uniqKey="Lindsey S" first="Susan C" last="Lindsey">Susan C. 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Smit</name><affiliation><nlm:affiliation>10 Department of Internal Medicine, Radboud University Medical Centre , Nijmegen, The Netherlands .</nlm:affiliation></affiliation></author><author><name sortKey="Meijer, Johannes Arnoldus Anthonius" sort="Meijer, Johannes Arnoldus Anthonius" uniqKey="Meijer J" first="Johannes Arnoldus Anthonius" last="Meijer">Johannes Arnoldus Anthonius Meijer</name><affiliation><nlm:affiliation>11 Department of Internal Medicine, Albert Schweitzer Hospital , Dordrecht, The Netherlands .</nlm:affiliation></affiliation></author><author><name sortKey="Duntas, Leonidas H" sort="Duntas, Leonidas H" uniqKey="Duntas L" first="Leonidas H" last="Duntas">Leonidas H. Duntas</name><affiliation><nlm:affiliation>12 Evgenidion Hospital, Unit of Endocrinology, Diabetes and Metabolism, Thyroid Section, University of Athens , Athens, Greece .</nlm:affiliation></affiliation></author><author><name sortKey="Sharma, Neil" sort="Sharma, Neil" uniqKey="Sharma N" first="Neil" last="Sharma">Neil Sharma</name><affiliation><nlm:affiliation>13 Institute of Head and Neck Studies and Education, University of Birmingham , Birmingham, United Kingdom .</nlm:affiliation></affiliation></author><author><name sortKey="Costante, Giuseppe" sort="Costante, Giuseppe" uniqKey="Costante G" first="Giuseppe" last="Costante">Giuseppe Costante</name><affiliation><nlm:affiliation>14 Department of Medicine, Institut Jules Bordet , Brussels, Belgium .</nlm:affiliation></affiliation></author><author><name sortKey="Filetti, Sebastiano" sort="Filetti, Sebastiano" uniqKey="Filetti S" first="Sebastiano" last="Filetti">Sebastiano Filetti</name><affiliation><nlm:affiliation>15 Dipartimento Di Medicina Interna, University of Roma La Sapienza , Rome, Italy .</nlm:affiliation></affiliation></author><author><name sortKey="Sippel, Rebecca S" sort="Sippel, Rebecca S" uniqKey="Sippel R" first="Rebecca S" last="Sippel">Rebecca S. Sippel</name><affiliation><nlm:affiliation>3 Section of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.</nlm:affiliation></affiliation></author><author><name sortKey="Biondi, Bernadette" sort="Biondi, Bernadette" uniqKey="Biondi B" first="Bernadette" last="Biondi">Bernadette Biondi</name><affiliation><nlm:affiliation>4 Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples, Italy .</nlm:affiliation></affiliation></author><author><name sortKey="Topliss, Duncan J" sort="Topliss, Duncan J" uniqKey="Topliss D" first="Duncan J" last="Topliss">Duncan J. Topliss</name><affiliation><nlm:affiliation>7 Department of Endocrinology and Diabetes, Alfred Health, Monash University , Melbourne, Australia .</nlm:affiliation></affiliation></author><author><name sortKey="Pacini, Furio" sort="Pacini, Furio" uniqKey="Pacini F" first="Furio" last="Pacini">Furio Pacini</name><affiliation><nlm:affiliation>6 Section of Endocrinology and Metabolism, Department of Medical, Surgical, and Neurological Sciences, University of Siena , Siena, Italy .</nlm:affiliation></affiliation></author><author><name sortKey="Maciel, Rui M B" sort="Maciel, Rui M B" uniqKey="Maciel R" first="Rui M B" last="Maciel">Rui M B. Maciel</name><affiliation><nlm:affiliation>5 Division of Endocrinology, Laboratory of Molecular and Translational Endocrinology, Department of Medicine, Federal University of Sao Paulo , São Paulo, Brazil .</nlm:affiliation></affiliation></author><author><name sortKey="Walz, Patrick C" sort="Walz, Patrick C" uniqKey="Walz P" first="Patrick C" last="Walz">Patrick C. Walz</name><affiliation><nlm:affiliation>1 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center , Columbus, Ohio.</nlm:affiliation></affiliation></author><author><name sortKey="Kloos, Richard T" sort="Kloos, Richard T" uniqKey="Kloos R" first="Richard T" last="Kloos">Richard T. Kloos</name><affiliation><nlm:affiliation>16 Veracyte, Inc. , South San Francisco, California.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2016">2016</date><idno type="RBID">pubmed:27604949</idno><idno type="pmid">27604949</idno><idno type="doi">10.1089/thy.2016.0255</idno><idno type="wicri:Area/PubMed/Corpus">001664</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001664</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study.</title><author><name sortKey="Essig, Garth F" sort="Essig, Garth F" uniqKey="Essig G" first="Garth F" last="Essig">Garth F. Essig</name><affiliation><nlm:affiliation>1 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center , Columbus, Ohio.</nlm:affiliation></affiliation></author><author><name sortKey="Porter, Kyle" sort="Porter, Kyle" uniqKey="Porter K" first="Kyle" last="Porter">Kyle Porter</name><affiliation><nlm:affiliation>2 Center for Biostatistics, The Ohio State University Wexner Medical Center , Columbus, Ohio.</nlm:affiliation></affiliation></author><author><name sortKey="Schneider, David" sort="Schneider, David" uniqKey="Schneider D" first="David" last="Schneider">David Schneider</name><affiliation><nlm:affiliation>3 Section of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.</nlm:affiliation></affiliation></author><author><name sortKey="Arpaia, Debora" sort="Arpaia, Debora" uniqKey="Arpaia D" first="Debora" last="Arpaia">Debora Arpaia</name><affiliation><nlm:affiliation>4 Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples, Italy .</nlm:affiliation></affiliation></author><author><name sortKey="Lindsey, Susan C" sort="Lindsey, Susan C" uniqKey="Lindsey S" first="Susan C" last="Lindsey">Susan C. Lindsey</name><affiliation><nlm:affiliation>5 Division of Endocrinology, Laboratory of Molecular and Translational Endocrinology, Department of Medicine, Federal University of Sao Paulo , São Paulo, Brazil .</nlm:affiliation></affiliation></author><author><name sortKey="Busonero, Giulia" sort="Busonero, Giulia" uniqKey="Busonero G" first="Giulia" last="Busonero">Giulia Busonero</name><affiliation><nlm:affiliation>6 Section of Endocrinology and Metabolism, Department of Medical, Surgical, and Neurological Sciences, University of Siena , Siena, Italy .</nlm:affiliation></affiliation></author><author><name sortKey="Fineberg, Daniel" sort="Fineberg, Daniel" uniqKey="Fineberg D" first="Daniel" last="Fineberg">Daniel Fineberg</name><affiliation><nlm:affiliation>7 Department of Endocrinology and Diabetes, Alfred Health, Monash University , Melbourne, Australia .</nlm:affiliation></affiliation></author><author><name sortKey="Fruci, Barbara" sort="Fruci, Barbara" uniqKey="Fruci B" first="Barbara" last="Fruci">Barbara Fruci</name><affiliation><nlm:affiliation>8 Département of Endocrinology and Nephrology, Pierre Oudot Hospital , Bourgoin-Jallieu, France .</nlm:affiliation></affiliation></author><author><name sortKey="Boelaert, Kristien" sort="Boelaert, Kristien" uniqKey="Boelaert K" first="Kristien" last="Boelaert">Kristien Boelaert</name><affiliation><nlm:affiliation>9 School of Clinical and Experimental Medicine, Centre for Endocrinology, Diabetes, and Metabolism, Institute of Biomedical Research, University of Birmingham , Birmingham, United Kingdom .</nlm:affiliation></affiliation></author><author><name sortKey="Smit, Johannes W" sort="Smit, Johannes W" uniqKey="Smit J" first="Johannes W" last="Smit">Johannes W. Smit</name><affiliation><nlm:affiliation>10 Department of Internal Medicine, Radboud University Medical Centre , Nijmegen, The Netherlands .</nlm:affiliation></affiliation></author><author><name sortKey="Meijer, Johannes Arnoldus Anthonius" sort="Meijer, Johannes Arnoldus Anthonius" uniqKey="Meijer J" first="Johannes Arnoldus Anthonius" last="Meijer">Johannes Arnoldus Anthonius Meijer</name><affiliation><nlm:affiliation>11 Department of Internal Medicine, Albert Schweitzer Hospital , Dordrecht, The Netherlands .</nlm:affiliation></affiliation></author><author><name sortKey="Duntas, Leonidas H" sort="Duntas, Leonidas H" uniqKey="Duntas L" first="Leonidas H" last="Duntas">Leonidas H. Duntas</name><affiliation><nlm:affiliation>12 Evgenidion Hospital, Unit of Endocrinology, Diabetes and Metabolism, Thyroid Section, University of Athens , Athens, Greece .</nlm:affiliation></affiliation></author><author><name sortKey="Sharma, Neil" sort="Sharma, Neil" uniqKey="Sharma N" first="Neil" last="Sharma">Neil Sharma</name><affiliation><nlm:affiliation>13 Institute of Head and Neck Studies and Education, University of Birmingham , Birmingham, United Kingdom .</nlm:affiliation></affiliation></author><author><name sortKey="Costante, Giuseppe" sort="Costante, Giuseppe" uniqKey="Costante G" first="Giuseppe" last="Costante">Giuseppe Costante</name><affiliation><nlm:affiliation>14 Department of Medicine, Institut Jules Bordet , Brussels, Belgium .</nlm:affiliation></affiliation></author><author><name sortKey="Filetti, Sebastiano" sort="Filetti, Sebastiano" uniqKey="Filetti S" first="Sebastiano" last="Filetti">Sebastiano Filetti</name><affiliation><nlm:affiliation>15 Dipartimento Di Medicina Interna, University of Roma La Sapienza , Rome, Italy .</nlm:affiliation></affiliation></author><author><name sortKey="Sippel, Rebecca S" sort="Sippel, Rebecca S" uniqKey="Sippel R" first="Rebecca S" last="Sippel">Rebecca S. Sippel</name><affiliation><nlm:affiliation>3 Section of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.</nlm:affiliation></affiliation></author><author><name sortKey="Biondi, Bernadette" sort="Biondi, Bernadette" uniqKey="Biondi B" first="Bernadette" last="Biondi">Bernadette Biondi</name><affiliation><nlm:affiliation>4 Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples, Italy .</nlm:affiliation></affiliation></author><author><name sortKey="Topliss, Duncan J" sort="Topliss, Duncan J" uniqKey="Topliss D" first="Duncan J" last="Topliss">Duncan J. Topliss</name><affiliation><nlm:affiliation>7 Department of Endocrinology and Diabetes, Alfred Health, Monash University , Melbourne, Australia .</nlm:affiliation></affiliation></author><author><name sortKey="Pacini, Furio" sort="Pacini, Furio" uniqKey="Pacini F" first="Furio" last="Pacini">Furio Pacini</name><affiliation><nlm:affiliation>6 Section of Endocrinology and Metabolism, Department of Medical, Surgical, and Neurological Sciences, University of Siena , Siena, Italy .</nlm:affiliation></affiliation></author><author><name sortKey="Maciel, Rui M B" sort="Maciel, Rui M B" uniqKey="Maciel R" first="Rui M B" last="Maciel">Rui M B. Maciel</name><affiliation><nlm:affiliation>5 Division of Endocrinology, Laboratory of Molecular and Translational Endocrinology, Department of Medicine, Federal University of Sao Paulo , São Paulo, Brazil .</nlm:affiliation></affiliation></author><author><name sortKey="Walz, Patrick C" sort="Walz, Patrick C" uniqKey="Walz P" first="Patrick C" last="Walz">Patrick C. Walz</name><affiliation><nlm:affiliation>1 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center , Columbus, Ohio.</nlm:affiliation></affiliation></author><author><name sortKey="Kloos, Richard T" sort="Kloos, Richard T" uniqKey="Kloos R" first="Richard T" last="Kloos">Richard T. Kloos</name><affiliation><nlm:affiliation>16 Veracyte, Inc. , South San Francisco, California.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Thyroid : official journal of the American Thyroid Association</title><idno type="eISSN">1557-9077</idno><imprint><date when="2016" type="published">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Current 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.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">27604949</PMID><DateCreated><Year>2016</Year><Month>09</Month><Day>08</Day></DateCreated><DateRevised><Year>2017</Year><Month>09</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1557-9077</ISSN><JournalIssue CitedMedium="Internet"><Volume>26</Volume><Issue>11</Issue><PubDate><Year>2016</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Thyroid : official journal of the American Thyroid Association</Title><ISOAbbreviation>Thyroid</ISOAbbreviation></Journal><ArticleTitle>Multifocality in Sporadic Medullary Thyroid Carcinoma: An International Multicenter Study.</ArticleTitle><Pagination><MedlinePgn>1563-1572</MedlinePgn></Pagination><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Current 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.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A 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.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Patients 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.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">The 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.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Essig</LastName><ForeName>Garth F</ForeName><Initials>GF</Initials><Suffix>Jr</Suffix><AffiliationInfo><Affiliation>1 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center , Columbus, Ohio.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Porter</LastName><ForeName>Kyle</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>2 Center for Biostatistics, The Ohio State University Wexner Medical Center , Columbus, Ohio.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schneider</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>3 Section of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arpaia</LastName><ForeName>Debora</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>4 Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples, Italy .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lindsey</LastName><ForeName>Susan C</ForeName><Initials>SC</Initials><AffiliationInfo><Affiliation>5 Division of Endocrinology, Laboratory of Molecular and Translational Endocrinology, Department of Medicine, Federal University of Sao Paulo , São Paulo, Brazil .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Busonero</LastName><ForeName>Giulia</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>6 Section of Endocrinology and Metabolism, Department of Medical, Surgical, and Neurological Sciences, University of Siena , Siena, Italy .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fineberg</LastName><ForeName>Daniel</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>7 Department of Endocrinology and Diabetes, Alfred Health, Monash University , Melbourne, Australia .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fruci</LastName><ForeName>Barbara</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>8 Département of Endocrinology and Nephrology, Pierre Oudot Hospital , Bourgoin-Jallieu, France .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boelaert</LastName><ForeName>Kristien</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>9 School of Clinical and Experimental Medicine, Centre for Endocrinology, Diabetes, and Metabolism, Institute of Biomedical Research, University of Birmingham , Birmingham, United Kingdom .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Smit</LastName><ForeName>Johannes W</ForeName><Initials>JW</Initials><AffiliationInfo><Affiliation>10 Department of Internal Medicine, Radboud University Medical Centre , Nijmegen, The Netherlands .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Meijer</LastName><ForeName>Johannes Arnoldus Anthonius</ForeName><Initials>JA</Initials><AffiliationInfo><Affiliation>11 Department of Internal Medicine, Albert Schweitzer Hospital , Dordrecht, The Netherlands .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Duntas</LastName><ForeName>Leonidas H</ForeName><Initials>LH</Initials><AffiliationInfo><Affiliation>12 Evgenidion Hospital, Unit of Endocrinology, Diabetes and Metabolism, Thyroid Section, University of Athens , Athens, Greece .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sharma</LastName><ForeName>Neil</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>13 Institute of Head and Neck Studies and Education, University of Birmingham , Birmingham, United Kingdom .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Costante</LastName><ForeName>Giuseppe</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>14 Department of Medicine, Institut Jules Bordet , Brussels, Belgium .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Filetti</LastName><ForeName>Sebastiano</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>15 Dipartimento Di Medicina Interna, University of Roma La Sapienza , Rome, Italy .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sippel</LastName><ForeName>Rebecca S</ForeName><Initials>RS</Initials><AffiliationInfo><Affiliation>3 Section of Endocrine Surgery, University of Wisconsin School of Medicine and Public Health , Madison, Wisconsin.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Biondi</LastName><ForeName>Bernadette</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>4 Department of Clinical Medicine and Surgery, University of Naples Federico II , Naples, Italy .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Topliss</LastName><ForeName>Duncan J</ForeName><Initials>DJ</Initials><AffiliationInfo><Affiliation>7 Department of Endocrinology and Diabetes, Alfred Health, Monash University , Melbourne, Australia .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pacini</LastName><ForeName>Furio</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>6 Section of Endocrinology and Metabolism, Department of Medical, Surgical, and Neurological Sciences, University of Siena , Siena, Italy .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Maciel</LastName><ForeName>Rui M B</ForeName><Initials>RM</Initials><AffiliationInfo><Affiliation>5 Division of Endocrinology, Laboratory of Molecular and Translational Endocrinology, Department of Medicine, Federal University of Sao Paulo , São Paulo, Brazil .</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Walz</LastName><ForeName>Patrick C</ForeName><Initials>PC</Initials><AffiliationInfo><Affiliation>1 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center , Columbus, Ohio.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kloos</LastName><ForeName>Richard T</ForeName><Initials>RT</Initials><AffiliationInfo><Affiliation>16 Veracyte, Inc. , South San Francisco, California.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><GrantID>G0601811</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>MR/J001414/1</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>P50 CA168505</GrantID><Acronym>CA</Acronym><Agency>NCI NIH HHS</Agency><Country>United States</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2016</Year><Month>10</Month><Day>11</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Thyroid</MedlineTA><NlmUniqueID>9104317</NlmUniqueID><ISSNLinking>1050-7256</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">humans</Keyword><Keyword MajorTopicYN="N">medullary thyroid carcinoma</Keyword><Keyword MajorTopicYN="N">multifocality</Keyword><Keyword MajorTopicYN="N">surgery</Keyword><Keyword MajorTopicYN="N">thyroid neoplasm</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2016</Year><Month>11</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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