A Ríos1,2, M A Rodríguez3, J A Puñal4, P Moreno5, E Mercader6, E Ferrero7, J Ruiz-Pardo8, M A Morlán9, J Martín10, M Durán-Poveda11,12, J M Bravo13, D Casanova14, M P Salvador Egea15, N M Torregrosa16, A Exposito-Rodríguez17, G Martínez-Fernández18, A M Carrión19, O Vidal20, F Herrera21, G Ruiz-Merino22, J M Rodríguez23,3. 1. 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. arzrios@um.es. 2. Departamento de Cirugía, Pediatría Obstetricia, Y Ginecología, Universidad de Murcia, Murcia, Spain. arzrios@um.es. 3. Departamento de Cirugía, Pediatría Obstetricia, Y Ginecología, Universidad de Murcia, Murcia, Spain. 4. Servicio de Cirugía General Y Aparato Digestivo, C.H.U, Santiago de Compostela, Spain. 5. Cirugía Endocrina, Hospital Universitario de Bellvitge, L´Hospitalet de Llobregat, Barcelona, Spain. 6. Sección de Cirugía Endocrino-Metabólica, Hospital General Universitario Gregorio Marañón, Madrid, Spain. 7. Servicio de Cirugía General, Aparato Digestivo Y Trasplante de Órganos Abdominales, Hospital Universitario, 12 de Octubre, Madrid, Spain. 8. Servicio de Cirugía General Y del Aparato Digestivo, Hospital Universitario Torrecárdenas, Almeria, Spain. 9. Servicio de Cirugía General Y del Aparato Digestivo, Hospital Virgen de La Salud, Toledo, Spain. 10. Servicio de Cirugía General Y Aparato Digestivo, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain. 11. Servicio de Cirugía General Y del Aparato Digestivo, Hospital Universitario Rey Juan Carlos. Móstoles, Madrid, Spain. 12. Facultad de Ciencias de La Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. 13. Servicio de Cirugía General Y del Aparato Digestivo, Hospital de La Princesa, Madrid, Spain. 14. Servicio de Cirugía General Y del Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, Spain. 15. Servicio de Cirugía General Y Digestiva, Complejo Hospitalario de Navarra, Pamplona, Spain. 16. Servicio de Cirugía General Y del Aparato Digestivo, Hospital de Santa Lucia, Cartagena, Murcia, Spain. 17. Servicio de Cirugía General Y del Aparato Digestivo, Hospital de Basurto, Bizkaia, Spain. 18. Unidad de Cirugía Endocrina, Servicio de Cirugía General (Hospital Universitario de Cruces), Barakaldo, Bizkaia, Spain. 19. Servicio de Cirugía, Hospital General Universitario de Alicante, Alicante, Spain. 20. Cirugía General Y del Aparato Digestivo, Hospital Universitario de Burgos, Burgos, Spain. 21. Servicio de Cirugía General, Hospital General Básico Santa Ana, Motril, Granada, Spain. 22. FFIS, Fundación Para La Formación E Investigación Sanitarias de La Región de Murcia, Murcia, Spain. 23. 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.
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.
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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