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Should Total Thyroidectomy Be Recommended for Patients with Familial Non-medullary Thyroid Cancer?

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Abstract

Background

It is unknown whether familial non-medullary thyroid cancer (FNMTC) has more aggressive clinical features and a worse prognosis than sporadic non-medullary thyroid cancer (SNMTC).

Methods

We retrospectively reviewed 2894 patients with differentiated thyroid cancer who underwent primary thyroidectomy, identified 391 FNMTC cases, and compared the prevalence, surgical extension, and clinicopathologic features of FNMTC and SNMTC.

Results

A family history of thyroid cancer was noted in 391 patients (13.5%), with 85% having two affected relatives and 15% with ≥3 affected relatives. A sibling was affected in 52.9% of cases, and in 47.1%, both parent and child were affected. There were no significant between-group differences in sex, age, tumor size, extrathyroidal extension, or central lymph node metastases. Significantly more patients with FNMTC exhibited multifocal disease (p = 0.020) or benign nodules (p = 0.015). Lateral neck lymph node metastases were noted in 6.6% (SNMTC) and 9.7% (FNMTC, p = 0.021) of patients. Multifocality and combined benign masses were more frequently observed in patients with FNMTC in multivariate analysis. In the FNMTC group, seven experienced disease recurrence, with no mortality noted during follow-up.

Conclusions

FNMTC is not more aggressive than SNMTC; however, FNMTC should be treated with total thyroidectomy because of the increased disease multifocality and the presence of benign nodules. Lateral neck lymph node metastases were more likely in patients with FNMTC, although we could not estimate prognosis. All patients with thyroid cancer should be checked for family disease history and undergo preoperative ultrasonography to determine the extent of node dissection and the need for total thyroidectomy.

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References

  1. Davies L, Welch HG (2006) Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 295:2164–2167

    Article  CAS  PubMed  Google Scholar 

  2. Ahn HS, Kim HJ, Welch HG (2014) Korea's thyroid-cancer “epidemic”—screening and overdiagnosis. N Engl J Med 371:1765–1767

    Article  PubMed  Google Scholar 

  3. Mazeh H, Sippel RS (2013) Familial nonmedullary thyroid carcinoma. Thyroid 23:1049–1056

    Article  PubMed  Google Scholar 

  4. Sippel RS, Caron NR, Clark OH (2007) An evidence-based approach to familial nonmedullary thyroid cancer: screening, clinical management, and follow-up. World J Surg 31:924–933. https://doi.org/10.1007/s00268-006-0847-1

    Article  PubMed  Google Scholar 

  5. Robinson DW, Orr TG (1955) Carcinoma of the thyroid and other diseases of the thyroid in identical twins. AMA Arch Surg 70:923–928

    Article  CAS  PubMed  Google Scholar 

  6. Sturgeon C, Clark OH (2005) Familial nonmedullary thyroid cancer. Thyroid 15:588–593

    Article  PubMed  Google Scholar 

  7. Park YJ, Ahn HY, Choi HS et al (2012) The long-term outcomes of the second generation of familial nonmedullary thyroid carcinoma are more aggressive than sporadic cases. Thyroid 22:356–362

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Sung TY, Lee YM, Yoon JH et al (2015) Surgical management of familial papillary thyroid microcarcinoma: a single institution study of 94 cases. World J Surg 39:1930–1935. https://doi.org/10.1007/s00268-015-3064-y

    Article  PubMed  Google Scholar 

  9. Alsanea O, Clark OH (2001) Familial thyroid cancer. Curr Opin Oncol 13:44–51

    Article  CAS  PubMed  Google Scholar 

  10. Ito Y, Kakudo K, Hirokawa M et al (2009) Biological behavior and prognosis of familial papillary thyroid carcinoma. Surgery 145:100–105

    Article  PubMed  Google Scholar 

  11. Maxwell EL, Hall FT, Freeman JL (2004) Familial non-medullary thyroid cancer: a matched-case control study. Laryngoscope 114:2182–2186

    Article  PubMed  Google Scholar 

  12. Moses W, Weng J, Kebebew E (2011) Prevalence, clinicopathologic features, and somatic genetic mutation profile in familial versus sporadic nonmedullary thyroid cancer. Thyroid 21:367–371

    Article  PubMed  PubMed Central  Google Scholar 

  13. Uchino S, Noguchi S, Kawamoto H et al (2002) Familial nonmedullary thyroid carcinoma characterized by multifocality and a high recurrence rate in a large study population. World J Surg 26:897–902. https://doi.org/10.1007/s00268-002-6615-y

    Article  PubMed  Google Scholar 

  14. Wang X, Cheng W, Li J et al (2015) Endocrine tumours: familial nonmedullary thyroid carcinoma is a more aggressive disease: a systematic review and meta-analysis. Eur J Endocrinol 172:R253–262

    Article  CAS  PubMed  Google Scholar 

  15. Charkes ND (2006) On the prevalence of familial nonmedullary thyroid cancer in multiply affected kindreds. Thyroid 16:181–186

    Article  PubMed  Google Scholar 

  16. McDonald TJ, Driedger AA, Garcia BM et al (2011) Familial papillary thyroid carcinoma: a retrospective analysis. J Oncol 2011:948786

    Article  PubMed  PubMed Central  Google Scholar 

  17. Triponez F, Wong M, Sturgeon C et al (2006) Does familial non-medullary thyroid cancer adversely affect survival? World J Surg 30:787–793. https://doi.org/10.1007/s00268-005-0398-x

    Article  PubMed  Google Scholar 

  18. Charkes ND (1998) On the prevalence of familial nonmedullary thyroid cancer. Thyroid 8:857–858

    Article  CAS  PubMed  Google Scholar 

  19. Tavarelli M, Russo M, Terranova R et al (2015) Familial non-medullary thyroid cancer represents an independent risk factor for increased cancer aggressiveness: a retrospective analysis of 74 families. Front Endocrinol (Lausanne) 6:117

    Article  Google Scholar 

  20. Alsanea O, Wada N, Ain K et al (2000) Is familial non-medullary thyroid carcinoma more aggressive than sporadic thyroid cancer? A multicenter series. Surgery 128:1043–1050 (discussion 1050–1041)

    Article  CAS  PubMed  Google Scholar 

  21. Robenshtok E, Tzvetov G, Grozinsky-Glasberg S et al (2011) Clinical characteristics and outcome of familial nonmedullary thyroid cancer: a retrospective controlled study. Thyroid 21:43–48

    Article  PubMed  Google Scholar 

  22. Loh KC, Lo JC, Greenspan FS et al (1997) Familial papillary thyroid cancer: a case report. Ann Acad Med Singap 26:503–506

    CAS  PubMed  Google Scholar 

  23. Zhang Q, Yang S, Meng XY et al (2016) Clinical analysis of familial nonmedullary thyroid carcinoma. World J Surg 40:570–573. https://doi.org/10.1007/s00268-015-3342-8

    Article  PubMed  Google Scholar 

  24. Mazeh H, Benavidez J, Poehls JL et al (2012) In patients with thyroid cancer of follicular cell origin, a family history of nonmedullary thyroid cancer in one first-degree relative is associated with more aggressive disease. Thyroid 22:3–8

    Article  PubMed  Google Scholar 

  25. Capezzone M, Marchisotta S, Cantara S et al (2008) Familial non-medullary thyroid carcinoma displays the features of clinical anticipation suggestive of a distinct biological entity. Endocr Relat Cancer 15:1075–1081

    Article  CAS  PubMed  Google Scholar 

  26. Grossman RF, Tu SH, Duh QY et al (1995) Familial nonmedullary thyroid cancer. An emerging entity that warrants aggressive treatment. Arch Surg 130:892–897 (discussion 898–899)

    Article  CAS  PubMed  Google Scholar 

  27. Hay ID (1990) Papillary thyroid carcinoma. Endocrinol Metab Clin N Am 19:545–576

    Article  CAS  Google Scholar 

  28. Mazzaferri EL (1987) Papillary thyroid carcinoma: factors influencing prognosis and current therapy. Semin Oncol 14:315–332

    CAS  PubMed  Google Scholar 

  29. Pal T, Vogl FD, Chappuis PO et al (2001) Increased risk for nonmedullary thyroid cancer in the first degree relatives of prevalent cases of nonmedullary thyroid cancer: a hospital-based study. J Clin Endocrinol Metab 86:5307–5312

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

This work was funded by Ulsan University Hospital (Biomedical Research Center Promotion Fund 11-03).

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Authors and Affiliations

  1. Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, South Korea

    Yon Seon Kim & So Yeon Ju

  2. Department of Nuclear Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, South Korea

    Minjung Seo & Seol Hoon Park

  3. Department of Endocrinology, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, South Korea

    Eun Sook Kim

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  1. Yon Seon Kim
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  2. Minjung Seo
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Correspondence to Yon Seon Kim.

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Kim, Y.S., Seo, M., Park, S.H. et al. Should Total Thyroidectomy Be Recommended for Patients with Familial Non-medullary Thyroid Cancer?. World J Surg 44, 3022–3027 (2020). https://doi.org/10.1007/s00268-020-05473-7

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  • DOI: https://doi.org/10.1007/s00268-020-05473-7

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