A new threshold for perioperative risk: Calcitonin levels predict surgical outcomes in rare cancer syndrome
For patients with Multiple Endocrine Neoplasia type 2A (MEN2A), a hereditary cancer syndrome, deciding when to perform preventive thyroid surgery is a critical challenge. A new study provides a data-driven answer. Researchers analyzed 106 gene carriers who underwent surgery, finding that a preoperative basal calcitonin (bCTN) level below 28.25 ng/L was a powerful predictor of achieving an “excellent response”—complete biochemical and structural remission—after the operation. This threshold identified patients likely to have a favorable outcome with high specificity (95.5%), even when a small thyroid cancer was already present. The findings offer a clearer, biomarker-guided framework for timing surgical intervention to optimize long-term results.
Why it might matter to you: This research directly informs the perioperative management of a complex patient population. For anesthesiologists, understanding these predictive biomarkers is crucial for risk stratification and preoperative optimization when these patients present for thyroidectomy or related procedures. It underscores the importance of integrating specific endocrine lab values into the anesthetic plan, particularly for assessing and managing potential hemodynamic stability in patients with related conditions like pheochromocytoma.
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