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Is unicentric familial papillary thyroid microcarcinoma different from multicentric?

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Abstract

Background

Familial papillary thyroid microcarcinoma (FPTMC) appears to be more aggressive than sporadic papillary thyroid microcarcinoma (SPTMC). However, there are authors who indicate that unicentric FPTMC has a similar prognosis to SPTMC. The objective is to analyze whether unicentric FPTMC has a better prognosis than multicentric FPTMC.

Design and methods

Type of study: National multicenter longitudinal analytical observational study. Study population: Patients with FPTMC. Study groups: Two groups were compared: Group A (unicentric FPTMC) vs. Group B (multicentric FPTMC). Study variables: It is analyzed whether between the groups there are: a) differentiating characteristics; and b) prognostic differences. Statistical analysis: Cox regression analysis and survival analysis.

Results

Ninety-four patients were included, 44% (n = 41) with unicentric FPTMC and 56% (n = 53) with multicentric FPTMC. No differences were observed between the groups according to socio-familial, clinical or histological variables. In the group B a more aggressive treatment was performed, with higher frequency of total thyroidectomy (99 vs. 78%; p = 0.003), lymph node dissection (41 vs. 15%; p = 0.005) and therapy with radioactive iodine (96 vs. 73%; p = 0.002). Tumor stage was similar in both groups (p = 0.237), with a higher number of T3 cases in the group B (24 vs. 5%; p = 0.009). After a mean follow-up of 90 ± 68.95 months, the oncological results were similar, with a similar disease persistence rate (9 vs. 5%; p = 0.337), disease recurrence rate (21 vs. 8%; p = 0.159) and disease-free survival (p = 0.075).

Conclusions

Unicentric FPTMC should not be considered as a SPTMC due to its prognosis is similar to multicentric FPTMC.

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Data availability

The data underlying this article will be shared on reasonable request to the corresponding author (Dr. Ríos).

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Acknowledgements

Thank the Spanish Association of Surgeons and the Endocrine Surgery Section for their support in carrying out this work. Thank the 30 Spanish Endocrine Surgery Units for having collaborated in the realization of this project and for having provided the data.

Author contributions

Authorship: Contribution to study of the Authors: 1) Conception and design: A.R. 2) Acquisition of a subtantial portion of data: A.R., J.R.-P., A.B.-R., J.A.P., P.M, E.M., E.F, M.A.M., J.M., M.D., J.M.B., D.C., M.P.S.E., N.M.T., A.E.R., G.M.F., A.M.C., O.V., F.H., G.R.-M., J.M.R. 3) Analysis and interpretation of data: A.R., J.R.-P., A.B.-R., J.A.P., P.M., E.M., E.F., M.A.M., J.M., M.D., J.M.B., D.C., M.P.S.-E., N.M.T., A.E.-R., G.M.-F., A.M.C., O.V., F.H., G.R.-M., J.M.R. 4) Drafting of the manuscript: A.R. 5) Critical revision of the manuscript for important intellectual content: A.R., J.R.-P., A.B.-R., J.A.P., P.M., E.M., E.F., M.A.M., J.M., M.D., J.M.B., D.C., M.P.S.-E., N.M.T., A.E.-R., G.M.-F., A.M.C., O.V., F.H., G.R.-M., J.M.R. 6) Statistical expertise: A.R., G.R.-M. 7) Obtaining funding for this project or study: A.R. 8) Supervision: A.R. 9) Final approval of the version to be published: A.R., J.R.-P., A.B.-R., J.A.P., P.M., E.M., E.F., M.A.M., J.M., M.D., J.M.B., D.C., M.P.S.-E., N.M.T., A.E.-R., G.M.-F., A.M.C., O.V., F.H., G.R.-M., J.M.R. 10) Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: A.R., J.R.-P., A.B.-R., J.A.P., P.M., E.M., E.F., M.A.M., J.M., M.D., J.M.B., D.C., M.P.S.-E., N.M.T., A.E.-R., G.M.-F., A.M.C., O.V., FH., G.R.-M., J.M.R.

Author information

Authors and Affiliations

  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

    A. Ríos, A. Balaguer-Román & J. M. Rodríguez

  2. Departamento de Cirugía, Pediatría y Obstetricia, y Ginecología, Universidad de Murcia, Murcia, Spain

    A. Ríos, A. Balaguer-Román & J. M. Rodríguez

  3. Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Torrecardenas, Almería, Spain

    J. Ruiz-Pardo

  4. Servicio de Cirugía General y Aparato Digestivo. C.H.U, Santiago de Compostela, Spain

    J. A. Puñal

  5. Cirugía Endocrina, Hospital Universitario de Bellvitge. L´Hospitalet de Llobregat, Barcelona, Spain

    P. Moreno

  6. Sección de Cirugía Endocrino-Metabólica, Hospital General Universitario Gregorio Marañón, Madrid, Spain

    E. Mercader

  7. Servicio de Cirugía General, Aparato Digestivo y Trasplante de Órganos Abdominales, Hospital Universitario 12 de Octubre, Madrid, Spain

    E. Ferrero

  8. Servicio de Cirugía General y del Aparato Digestivo, Hospital Virgen de la Salud, Toledo, Spain

    M. A. Morlán

  9. Servicio de Cirugía General y Aparato digestivo, Hospital Universitario Severo Ochoa. Leganés, Madrid, Spain

    J. Martín

  10. Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Rey Juan Carlos. Móstoles, Madrid, Spain

    M. Durán

  11. Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos. Alcorcón, Madrid, Spain

    M. Durán

  12. Servicio de Cirugía General y del Aparato Digestivo, Hospital de la Princesa, Madrid, Spain

    J. M. Bravo

  13. Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario Marqués de Valdecilla, Santander, Spain

    D. Casanova

  14. Servicio de Cirugía General y Digestiva, Complejo Hospitalario de Pamplona. Pamplona, Navarra, Spain

    M. P. Salvador-Egea

  15. Servicio de Cirugía General y del Aparato Digestivo, Hospital de Santa Lucia, Cartagena, Murcia, España

    N. M. Torregrosa

  16. Servicio de Cirugía General y del Aparato Digestivo, Hospital de Basurto, Vizcaya, España

    A. Exposito-Rodríguez

  17. Unidad de Cirugía Endocrina, Servicio de Cirugía General (Hospital Universitario de Cruces), Barakaldo (Bizkaia), Spain

    G. Martínez-Fernández

  18. Servicio de Cirugía, Hospital General Universitario de Alicante, Alicante, Spain

    A. M. Carrión

  19. Cirugía General y del Aparato Digestivo, Hospital Universitario de Burgos, Burgos, Spain

    O. Vidal

  20. Servicio de Cirugía General, Hospital General Básico Santa Ana, Motril (Granada), Spain

    F. Herrera

  21. FFIS, Fundación para la Formación e Investigación Sanitarias de la Región de Murcia, Murcia, España

    G. Ruiz-Merino

Authors
  1. A. Ríos
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  2. J. Ruiz-Pardo
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  3. A. Balaguer-Román
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  4. J. A. Puñal
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  6. E. Mercader
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  7. E. Ferrero
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  8. M. A. Morlán
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  9. J. Martín
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  10. M. Durán
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  11. J. M. Bravo
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  12. D. Casanova
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  13. M. P. Salvador-Egea
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  14. N. M. Torregrosa
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  15. A. Exposito-Rodríguez
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  16. G. Martínez-Fernández
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  17. A. M. Carrión
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  18. O. Vidal
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  19. F. Herrera
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  20. G. Ruiz-Merino
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  21. J. M. Rodríguez
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Correspondence to A. Ríos.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study protocol was approved by the committee of the Virgen de la Arrixaca University Hospital. Ethics Committee Code: 2021-2-13-HCUVA.

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Ríos, A., Ruiz-Pardo, J., Balaguer-Román, A. et al. Is unicentric familial papillary thyroid microcarcinoma different from multicentric?. Endocrine 82, 613–621 (2023). https://doi.org/10.1007/s12020-023-03455-y

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