Table 4.

Procedure for the treatment of medullary thyroid carcinoma based on the calcitonin level, as recommended by ESMO.

Calcitonin Level [pg/mL]	Procedure for MTC Treatment
	Neck US—Negative		Neck US—Positive
<20	TT		TT + bilateral CCLND + dissection of involved levels
20–50	TT +/− bilateral CCLND
50–200	TT + bilateral CCLND + ipsilateral LCLND *
200–500	TT + bilateral CCLND + bilateral LCLND *		TT + bilateral CCLND + dissection of involved levels + contralateral lymph node dissection
>500	M0	M1
	TT + bilateral CCLND + bilateral LCLND *	Range of surgery based on disease progression and symptoms

* At least IIa, III, IV. TT: total thyroidectomy; CCLND: central compartment lymph node dissection; LCLND: lateral compartment lymph node dissection.