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Rossella Elisei, Aldo Pinchera, Furio Pacini, Authors’ Response: Should Serum Calcitonin Be Routinely Measured in Patients with Thyroid Nodules—Will the Law Answer before Endocrinologists Do?, The Journal of Clinical Endocrinology & Metabolism, Volume 89, Issue 9, 1 September 2004, Page 4770, https://doi.org/10.1210/jc.2004-1177
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We are grateful to Dr. Deftos for the letter (1) that gives us the opportunity to make some observations regarding routine measurement of serum calcitonin (Ct) in patients with thyroid nodule(s). In our opinion, there are several lines of evidence (reviewed in Refs.2 and 3) that support the serum Ct measurement in association with fine-needle aspiration cytology (FNAC) as the most accurate tests for discovering medullary thyroid carcinoma (MTC). In addition, our experience on more than 10,000 patients demonstrates that when MTC is diagnosed by Ct screening, it has a better outcome likely due to the statistically significant lower stage of the disease at the diagnosis (2). Unfortunately, Hodak and Burman (3) could not discuss this issue because our paper was published just before their editorial. It is known that MTC is the most aggressive differentiated thyroid tumor, with a survival rate of 50% at 10 yr, and that the best prognostic factor is the stage of disease, with intrathyroidal tumors showing the best prognosis (4). The possibility of performing an early MTC diagnosis offered by the routine serum Ct measurement must be taken into account if we want to improve our capability to cure a disease that can be definitively cured only by the completeness of the initial surgical treatment. It is in fact well known that nowadays conventional chemotherapy and radiotherapy are ineffective to cure advanced MTC (5).
