Surgical Management of Familial Papillary Thyroid Microcarcinoma: A Single Institution Study of 94 Cases

World J Surg. 2015 Aug;39(8):1930-5. doi: 10.1007/s00268-015-3064-y.

Abstract

Background: Familial papillary thyroid carcinoma (familial PTC) is well known to present with aggressiveness; however, the characteristics and the prognostic outcomes of familial papillary thyroid microcarcinoma (familial micro-PTC) are not well established. The overall aim of this study was to analyze the clinicopathological outcomes of familial micro-PTC.

Methods: Between 1996 and 2006, 2071 patients underwent thyroid surgery for papillary thyroid carcinoma. The clinicopathological outcomes for familial PTC and sporadic PTC were compared, and familial micro-PTC data were sub-analyzed.

Results: There were significant differences in multifocality, bilaterality, extent of surgery, and recurrence between familial PTC and sporadic PTC (p<0.05). There was no significant difference in the number of affected family members in the familial PTC group. In patients with familial micro-PTC, less aggressiveness was noted in multifocality, extrathyroidal invasion, tumor stage at time of initial surgery, central lymph node metastasis, and recurrence than in those with familial PTC tumors>1 cm in diameter (p<0.05). The multivariate analysis including recurrence showed no significant difference between familial micro-PTC patients and sporadic micro-PTC patients.

Conclusion: When familial PTC was compared with sporadic PTC, our results support the recommendation for more invasive familial PTC surgery. However, familial micro-PTC outcomes differed from familial PTC tumors>1.0 cm in diameter. It was similar to sporadic micro-PTC, illustrating that familial micro-PTC is less aggressive and that a less invasive surgical treatment could be considered.

MeSH terms

  • Adult
  • Aged
  • Carcinoma / pathology
  • Carcinoma / secondary
  • Carcinoma / surgery
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / secondary
  • Carcinoma, Papillary / surgery*
  • Female
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / surgery
  • Neoplastic Syndromes, Hereditary / pathology
  • Neoplastic Syndromes, Hereditary / surgery*
  • Prognosis
  • Thyroid Cancer, Papillary
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / secondary
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy / methods

Supplementary concepts

  • Papillary Thyroid Microcarcinoma