A Machens



  1. Machens A, Dralle H. Correlation between the number of lymph node metastases and lung metastasis in papillary thyroid cancer. J Clin Endocrinol Metab. 2012;97:4375-82 pubmed publisher
    ..4 (N1b), and from 9.9-13.8 (for 1-20 lymph node metastases) to 4.7 (N1a). In PTC, categories of 0, 1-20, and more than 20 lymph node metastases correlate better with lung metastasis than current TNM N categories N0, N1a, and N1b. ..
  2. Machens A, Elwerr M, Schneider R, Lorenz K, Dralle H. Disease impacts more than age on operative morbidity in children with Graves' disease after total thyroidectomy. Surgery. 2018;164:993-997 pubmed publisher
    ..Disease impacts more than age on operative morbidity in children with Graves' disease after total thyroidectomy but is fairly low overall and rarely permanent in experienced hands. ..
  3. Machens A, Lorenz K, Dralle H. Histology-proven recurrence in the lateral or central neck after systematic neck dissection for medullary thyroid cancer. Endocrine. 2018;61:428-439 pubmed publisher
    ..Patients not biochemically cured, specifically those with extranodal growth at the initial operation, carry greater risks of node recurrence. ..
  4. Machens A, Dralle H. Outcome after thyroid surgery for metastasis from renal cell cancer. Surgery. 2010;147:65-71 pubmed publisher
    ..In this setting, extensive surgery aimed at preventing local complications should be embedded in a systemic treatment concept. ..
  5. Machens A, Dralle H. Multiple endocrine neoplasia type 2: achievements and current challenges. Clinics (Sao Paulo). 2012;67 Suppl 1:113-8 pubmed
    ..In this setting, functional characterization of mutant cells in vitro may generate helpful ancillary evidence with regard to the pathogenicity of gene variants in comparison with established mutations. ..
  6. Machens A, Dralle H. Biomarker-based risk stratification for previously untreated medullary thyroid cancer. J Clin Endocrinol Metab. 2010;95:2655-63 pubmed publisher
    ..Most newly diagnosed MTC patients, i.e. those with pretherapeutic basal calcitonin levels greater than 200 pg/ml, may need bilateral compartment-oriented neck surgery to reduce the number of reoperations. ..
  7. Machens A, Lorenz K, Dralle H. Individualization of lymph node dissection in RET (rearranged during transfection) carriers at risk for medullary thyroid cancer: value of pretherapeutic calcitonin levels. Ann Surg. 2009;250:305-10 pubmed publisher
    ..The usefulness of calcitonin thresholds to break down the block of carriers with increased calcitonin levels should be explored further. ..
  8. Machens A, Hauptmann S, Dralle H. Lymph node dissection in the lateral neck for completion in central node-positive papillary thyroid cancer. Surgery. 2009;145:176-81 pubmed publisher
    ..These histopathologic associations may provide a foundation for more evidence-based decisions regarding lymph node dissection of the lateral neck compartments in patients with node-positive papillary thyroid cancer. ..
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    Machens A, Hauptmann S, Dralle H. Disparities between male and female patients with thyroid cancers: sex difference or gender divide?. Clin Endocrinol (Oxf). 2006;65:500-5 pubmed
    ..Our data emphasize the need for earlier diagnosis and intervention in male patients to ensure that male sex will cease sometime to constitute an ominous prognostic marker of advanced thyroid cancer. ..

More Information


  1. Machens A, Hauptmann S, Dralle H. Prediction of lateral lymph node metastases in medullary thyroid cancer. Br J Surg. 2008;95:586-91 pubmed publisher
    ..These data may lay the groundwork for more informed decision-making regarding dissection of the lateral neck compartments. ..
  2. Machens A, Dralle H. Breach of the thyroid capsule and lymph node capsule in node-positive papillary and medullary thyroid cancer: Different biology. Eur J Surg Oncol. 2015;41:766-72 pubmed publisher
    ..This finding argues against mere transference of primary tumor characteristics to lymph nodes, pointing more to accrual of invasive properties by nodal tumor deposits. ..
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    Machens A, Dralle H. Multiple endocrine neoplasia type 2 and the RET protooncogene: from bedside to bench to bedside. Mol Cell Endocrinol. 2006;247:34-40 pubmed
  4. Machens A, Dralle H. Biological relevance of medullary thyroid microcarcinoma. J Clin Endocrinol Metab. 2012;97:1547-53 pubmed publisher
    ..0.3 nodes in hereditary and 8.8 vs. 0.4 nodes in sporadic disease; both P < 0.001). Sporadic and hereditary medullary thyroid microcarcinoma carry a significant risk of lymph node metastasis and postoperative calcitonin elevation. ..
  5. Machens A, Lorenz K, Dralle H. Constitutive RET tyrosine kinase activation in hereditary medullary thyroid cancer: clinical opportunities. J Intern Med. 2009;266:114-25 pubmed publisher
    ..Better comprehension of RET function should enable the design of targeted therapies for RET carriers beyond surgical cure in whom the DNA-based 'window of opportunity' has been missed. ..
  6. Machens A, Hoffmann F, Sekulla C, Dralle H. Importance of gender-specific calcitonin thresholds in screening for occult sporadic medullary thyroid cancer. Endocr Relat Cancer. 2009;16:1291-8 pubmed publisher
    ..These findings indicate that gender-specific calcitonin thresholds predict sporadic occult medullary thyroid cancer better than unisex thresholds. ..
  7. Machens A, Dralle H. Surgical cure rates of sporadic medullary thyroid cancer in the era of calcitonin screening. Eur J Endocrinol. 2016;175:219-28 pubmed publisher
    ..The independent contribution of routine calcitonin screening to these time-dependent changes warrants more research. ..
  8. Machens A, Lorenz K, Weber F, Dralle H. Geographic epidemiology of MTC families: unearthing European ancestral heritage. Endocr Relat Cancer. 2018;: pubmed publisher
    ..There is a clear need for additional geographical epidemiological studies, in particular to clarify the putative 'Germanic' ancestral heritage of RET p.L790F/c.2370G>T. ..
  9. Machens A, Dralle H. Advances in risk-oriented surgery for multiple endocrine neoplasia type 2. Endocr Relat Cancer. 2018;25:T41-T52 pubmed publisher
    ..The sweeping changes in the management of MEN2 since the new millenium hold the hope that death and major morbidity from this uncommon disease can be eliminated in our lifetime. ..
  10. Machens A, Frank Raue K, Lorenz K, Rondot S, Raue F, Dralle H. Clinical relevance of RET variants G691S, L769L, S836S and S904S to sporadic medullary thyroid cancer. Clin Endocrinol (Oxf). 2012;76:691-7 pubmed publisher
    ..This observation, along with the inconclusive evidence of previous association studies, calls for larger longitudinal association studies with age- and sex-matched external controls and additional functional studies of RET biology. ..
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    Machens A, Dralle H. Familial prevalence and age of RET germline mutations: implications for screening. Clin Endocrinol (Oxf). 2008;69:81-7 pubmed
    ..The current investigation was undertaken to provide such natural history data which are urgently needed to enable factual decision-making about DNA-based screening programmes for RET germline mutations...
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    Machens A, Schaaf L, Karges W, Frank Raue K, Bartsch D, Rothmund M, et al. Age-related penetrance of endocrine tumours in multiple endocrine neoplasia type 1 (MEN1): a multicentre study of 258 gene carriers. Clin Endocrinol (Oxf). 2007;67:613-22 pubmed
    ..This study was conducted to examine whether carriers of out-of-frame/truncating and in-frame MEN1 mutations differ in age-related tumour penetrance...
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    Machens A, Dralle H. Genotype-phenotype based surgical concept of hereditary medullary thyroid carcinoma. World J Surg. 2007;31:957-68 pubmed
    ..A comprehensive appraisal of this body of evidence using evidence-based methodology is pending...
  14. Machens A, Elwerr M, Thanh P, Lorenz K, Schneider R, Dralle H. Impact of central node dissection on postoperative morbidity in pediatric patients with suspected or proven thyroid cancer. Surgery. 2016;160:484-92 pubmed publisher
    ..The notion that the experience of the center and surgeons may be more important than the age of the child requires validation in independent series across different health care settings. ..
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    Machens A, Ukkat J, Hauptmann S, Dralle H. Abnormal carcinoembryonic antigen levels and medullary thyroid cancer progression: a multivariate analysis. Arch Surg. 2007;142:289-93; discussion 294 pubmed
    ..Medullary thyroid cancer cells are capable of secreting carcinoembyronic antigen (CEA). An abnormal preoperative CEA level may have important implications for the management of this condition...
  16. Machens A, Hauptmann S, Dralle H. Modification of multiple endocrine neoplasia 2A phenotype by cell membrane proximity of RET mutations in exon 10. Endocr Relat Cancer. 2009;16:171-7 pubmed publisher
    ..Although limited in numbers, these data suggested that membrane proximity is an important determinant of tumor development in carriers of RET mutations in exon 10...