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Item does not contain fulltext, 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. 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. 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. CONCLUSIONS: The 5.6% prevalence of bilateral foci in sMTC suggests that total thyroidectomy should remain the standard o

De rapporten -een vervolg op KIWA-mededelingen 71, 72 en 79- zijn verschenen op het KIWA/VWN-colloquium ’Diepinfiltratie en drinkwater' op 21 juni 1989. Ze hebben het karakter van 'proceedings'. Het zijn bundelingen van ervaringen die er zijn met diepinfiltratieputten en -plannen in de praktijk van vooral waterleidingbedrijven en ervaringen voortkomend uit het meer theoretisch gerichte KIWA-onderzoek naar aspecten van diepinfiltratie, met name putverstopping. De scheiding tussen theorie en praktijk valt echter niet altijd duidelijk te maken. De redactie hoopt dat de waarde van de rapporten zit in de 'handshake', de aansluiting van enerzijds de dure praktijkproeven op de theorie ('hoe de proeven op te zetten, waar te nemen en te interpreteren’). Anderzijds kennen we juist uit die praktijk de facetten die van belang zijn voor het onderzoek, bijvoorbeeld de processen die putverstopping veroorzaken. Dat laatste is van belang voor de formulering van het onderzoek. Dat blijft dus praktijkgericht.