Table 5.
`Codon-directed' timing of surgery based on ret mutations associated with hereditary MTC
| Risk level for MTC | ATA Risk level | Codon mutation | Age of prophylactic surgery |
|---|---|---|---|
|
| |||
| Level 3 (highest) | D | 883 | Within the first 6 months of life (preferably in the first year) |
| D | 918 | ||
| D | 922 | ||
|
| |||
| Level 2 (higher) | B | 611 | By age 5 |
| B | 618 | ||
| B | 620 | ||
| B/C | 634 | ||
|
| |||
| Level 1 (high) | B | 609 | By age 5–10 |
| B | 630 | ||
| A | 768 | ||
| A | 790 | ||
| A | 791 | ||
| A | 804 | ||
| A | 891 | ||
Adapted from “Management of Medullary Thyroid Cancer” in The Handbook of Endocrine Surgery (RS Sippel, and H Chen, eds.)