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Ríos A, Rodríguez MA, Puñal JA, Moreno P, Mercader E, Ferrero E, Ruiz-Pardo J, Morlán MA, Martín J, Durán-Poveda M, Bravo JM, Casanova D, Egea MPS, Torregrosa NM, Exposito-Rodríguez A, Martínez-Fernández G, Carrión AM, Vidal O, Herrera F, Ruiz-Merino G, Rodríguez JM. Biological behavior of familial papillary thyroid microcarcinoma: Spanish multicenter study. Langenbecks Arch Surg 2022; 407:3631-3642. [PMID: 36251077 DOI: 10.1007/s00423-022-02704-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 10/05/2022] [Indexed: 10/24/2022]
Abstract
PURPOSE Familial papillary thyroid microcarcinoma (FPTMC) can present a more aggressive behavior than the sporadic microcarcinoma. However, few studies have analyzed this situation. The objective is to analyze the recurrence rate of FPTMC and the prognostic factors which determine that recurrence in Spain. METHODS Spanish multicenter longitudinal analytical observational study was conducted. Patients with FPTMC received treatment with curative intent and presented cure criteria 6 months after treatment. Recurrence rate and disease-free survival (DFS) were analyzed. Two groups were analyzed: group A (no tumor recurrence) vs. group B (tumor recurrence). RESULTS Ninety-four patients were analyzed. During a mean follow-up of 73.3 ± 59.3 months, 13 recurrences of FPTMC (13.83%) were detected and mean DFS was 207.9 ± 11.5 months. There were multifocality in 56%, bilateral thyroid involvement in 30%, and vascular invasion in 7.5%; that is to say, they are tumors with histological factors of poor prognosis in a high percentage of cases. The main risk factors for recurrence obtained in the multivariate analysis were the tumor size (OR: 2.574, 95% CI 1.210-5.473; p = 0.014) and the assessment of the risk of recurrence of the American Thyroid Association (ATA), both intermediate risk versus low risk (OR: 125, 95% CI 10.638-1000; p < 0.001) and high risk versus low risk (OR: 45.454, 95% CI 5.405-333.333; p < 0.001). CONCLUSION FPTMC has a recurrence rate higher than sporadic cases. Poor prognosis is mainly associated with the tumor size and the risk of recurrence of the ATA.
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Affiliation(s)
- A Ríos
- Unidad de Cirugía Endocrina, Servicio de Cirugía General Y de Aparato Digestivo, Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca), Hospital Clínico Universitario Virgen de La Arrixaca, Servicio Murciano de Salud, Murcia, Spain. .,Departamento de Cirugía, Pediatría Obstetricia, Y Ginecología, Universidad de Murcia, Murcia, Spain.
| | - M A Rodríguez
- Departamento de Cirugía, Pediatría Obstetricia, Y Ginecología, Universidad de Murcia, Murcia, Spain
| | - J A Puñal
- Servicio de Cirugía General Y Aparato Digestivo, C.H.U, Santiago de Compostela, Spain
| | - P Moreno
- Cirugía Endocrina, Hospital Universitario de Bellvitge, L´Hospitalet de Llobregat, Barcelona, Spain
| | - E Mercader
- Sección de Cirugía Endocrino-Metabólica, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - E Ferrero
- Servicio de Cirugía General, Aparato Digestivo Y Trasplante de Órganos Abdominales, Hospital Universitario, 12 de Octubre, Madrid, Spain
| | - J Ruiz-Pardo
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital Universitario Torrecárdenas, Almeria, Spain
| | - M A Morlán
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital Virgen de La Salud, Toledo, Spain
| | - J Martín
- Servicio de Cirugía General Y Aparato Digestivo, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain
| | - M Durán-Poveda
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital Universitario Rey Juan Carlos. Móstoles, Madrid, Spain.,Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - J M Bravo
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital de La Princesa, Madrid, Spain
| | - D Casanova
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - M P Salvador Egea
- Servicio de Cirugía General Y Digestiva, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - N M Torregrosa
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital de Santa Lucia, Cartagena, Murcia, Spain
| | - A Exposito-Rodríguez
- Servicio de Cirugía General Y del Aparato Digestivo, Hospital de Basurto, Bizkaia, Spain
| | - G Martínez-Fernández
- Unidad de Cirugía Endocrina, Servicio de Cirugía General (Hospital Universitario de Cruces), Barakaldo, Bizkaia, Spain
| | - A M Carrión
- Servicio de Cirugía, Hospital General Universitario de Alicante, Alicante, Spain
| | - O Vidal
- Cirugía General Y del Aparato Digestivo, Hospital Universitario de Burgos, Burgos, Spain
| | - F Herrera
- Servicio de Cirugía General, Hospital General Básico Santa Ana, Motril, Granada, Spain
| | - G Ruiz-Merino
- FFIS, Fundación Para La Formación E Investigación Sanitarias de La Región de Murcia, Murcia, Spain
| | - J M Rodríguez
- Unidad de Cirugía Endocrina, Servicio de Cirugía General Y de Aparato Digestivo, Instituto Murciano de Investigación Bio-Sanitaria (IMIB-Arrixaca), Hospital Clínico Universitario Virgen de La Arrixaca, Servicio Murciano de Salud, Murcia, Spain.,Departamento de Cirugía, Pediatría Obstetricia, Y Ginecología, Universidad de Murcia, Murcia, Spain
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Capezzone M, Secchi C, Fralassi N, Cantara S, Brilli L, Ciuoli C, Pilli T, Maino F, Forleo R, Pacini F, Castagna MG. Should familial disease be considered as a negative prognostic factor in micropapillary thyroid carcinoma? J Endocrinol Invest 2019; 42:1205-1213. [PMID: 30927240 DOI: 10.1007/s40618-019-01039-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 03/20/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE An increased aggressiveness of familial papillary thyroid carcinoma (FPTC) compared with sporadic form has been reported. On the contrary, the biological behavior of familial microPTC (FmPTC) is still debated. To assess if familial diseases should be considered as a negative prognostic factor in mPTC, the clinical presentation and outcome of FmPTC and sporadic mPTC (SmPTC) were compared. METHODS We retrospectively analyzed 291 mPTC (SmPTC n = 248, FmPTC n = 43) patients followed for a median follow-up of 8.3 years. FmPTC was defined as the presence of PTC in two or more first-degree relatives, after excluding hereditary syndromes associated with PTC. RESULTS FmPTC patients had more frequently bilateral tumor (32.6% versus 16.5%, p = 0.01) and lymph node metastases at diagnosis (30.2% versus 14.9%, p = 0.02). At the first follow-up, FmPTC patients had a higher rate of structural disease and a lower rate of remission compared to SmPTC (p = 0.01). Also in a multivariate model, using a "CHAID tree-building algorithm", familial disease correlated with a worse clinical presentation and outcome of mPTC patients. Familial disease was associated with a higher rate of intermediate risk patients in non incidental mPTC and with a higher rate of structural incomplete response in mPTC without lymph node metastases (p = 0.01). CONCLUSIONS Like in macroPTC, the familial form of the diseases has been shown to be a negative prognostic factor also in mPTC, therefore, it should be highly regarded in the management of mPTC patients.
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Affiliation(s)
- M Capezzone
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - C Secchi
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - N Fralassi
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - S Cantara
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - L Brilli
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - C Ciuoli
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - T Pilli
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - F Maino
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - R Forleo
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - F Pacini
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - M G Castagna
- Section of Endocrinology and Metabolism, Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, Viale Bracci 1, 53100, Siena, Italy.
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