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Is unicentric familial papillary thyroid microcarcinoma different from multicentric?

Publicated to:Endocrine. 82 (3): 613-621 - 2023-12-01 82(3), DOI: 10.1007/s12020-023-03455-y

Authors: Ríos, A; Ruiz-Pardo, J; Balaguer-Román, A; Puñal, JA; Moreno, P; Mercader, E; Ferrero, E; Morlán, MA; Martín, J; Durán, M; Bravo, JM; Casanova, D; Salvador-Egea, MP; Torregrosa, NM; Exposito-Rodríguez, A; Martinez-Fernández, G; Carrión, AM; Vidal, O; Herrera, F; Ruiz-Merino, G; Rodríguez, JM

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Abstract

Background Familial papillary thyroid microcarcinoma (FPTMC) appears to be more aggressive than sporadic papillary thyroid microcarcinoma (SPTMC). However, there are authors who indicate that unicentric FPTMC has a similar prognosis to SPTMC. The objective is to analyze whether unicentric FPTMC has a better prognosis than multicentric FPTMC. Design and methods Type of study: National multicenter longitudinal analytical observational study. Study population: Patients with FPTMC. Study groups: Two groups were compared: Group A (unicentric FPTMC) vs. Group B (multicentric FPTMC). Study variables: It is analyzed whether between the groups there are: a) differentiating characteristics; and b) prognostic differences. Statistical analysis: Cox regression analysis and survival analysis. Results Ninety-four patients were included, 44% (n = 41) with unicentric FPTMC and 56% (n = 53) with multicentric FPTMC. No differences were observed between the groups according to socio-familial, clinical or histological variables. In the group B a more aggressive treatment was performed, with higher frequency of total thyroidectomy (99 vs. 78%; p = 0.003), lymph node dissection (41 vs. 15%; p = 0.005) and therapy with radioactive iodine (96 vs. 73%; p = 0.002). Tumor stage was similar in both groups (p = 0.237), with a higher number of T3 cases in the group B (24 vs. 5%; p = 0.009). After a mean follow-up of 90 +/- 68.95 months, the oncological results were similar, with a similar disease persistence rate (9 vs. 5%; p = 0.337), disease recurrence rate (21 vs. 8%; p = 0.159) and disease-free survival (p = 0.075). Conclusions Unicentric FPTMC should not be considered as a SPTMC due to its prognosis is similar to multicentric FPTMC.

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