Is unicentric familial papillary thyroid microcarcinoma different from multicentric?

Area of Science:

• Endocrinology
• Oncology
• Genetics

Background:

• Familial papillary thyroid microcarcinoma (FPTMC) is often considered more aggressive than sporadic cases.
• Some research suggests unicentric FPTMC may have a similar prognosis to sporadic papillary thyroid microcarcinoma (SPTMC).
• This study investigates the prognostic differences between unicentric and multicentric FPTMC.

Purpose of the Study:

• To determine if unicentric FPTMC has a better prognosis compared to multicentric FPTMC.
• To compare differentiating characteristics and prognostic outcomes between unicentric and multicentric FPTMC.
• To clarify the clinical behavior of FPTMC based on its growth pattern.

Main Methods:

• A national multicenter longitudinal analytical observational study was conducted.
• Ninety-four patients diagnosed with FPTMC were analyzed, comparing unicentric (Group A) and multicentric (Group B) cases.
• Cox regression and survival analyses were employed to assess prognostic differences.

Main Results:

• No significant differences in socio-familial, clinical, or histological variables were found between unicentric and multicentric FPTMC.
• Multicentric FPTMC cases received more aggressive treatment, including total thyroidectomy, lymph node dissection, and radioactive iodine therapy.
• Despite treatment differences, oncological outcomes were similar, with comparable disease persistence, recurrence rates, and disease-free survival between the two groups.

Conclusions:

• Unicentric FPTMC should not be equated with sporadic papillary thyroid microcarcinoma (SPTMC) due to its comparable prognosis to multicentric FPTMC.
• The findings suggest that the presence of multifocality in FPTMC does not inherently lead to a worse prognosis compared to unicentric FPTMC.
• Further research may be warranted to explore the nuances of FPTMC behavior and treatment strategies.