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.
Departamento de Cirugía, Pediatría y Obstetricia, y Ginecología, Universidad de Murcia, Murcia, Spain.
Endocrine. 2023 Dec;82(3):613-621. doi: 10.1007/s12020-023-03455-y. Epub 2023 Jul 25.
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.
Type of study: National multicenter longitudinal analytical observational study.
Patients with FPTMC.
Two groups were compared: Group A (unicentric FPTMC) vs. Group B (multicentric FPTMC).
It is analyzed whether between the groups there are: a) differentiating characteristics; and b) prognostic differences.
Cox regression analysis and survival analysis.
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).
Unicentric FPTMC should not be considered as a SPTMC due to its prognosis is similar to multicentric FPTMC.
家族性甲状腺乳头状微小癌（FPTMC）似乎比散发性甲状腺乳头状微小癌（SPTMC）更具侵袭性。然而，也有作者指出，单中心 FPTMC 的预后与 SPTMC 相似。目的是分析单中心 FPTMC 是否比多中心 FPTMC 具有更好的预后。
研究类型：全国多中心纵向分析观察性研究。
FPTMC 患者。
比较两组：A 组（单中心 FPTMC）与 B 组（多中心 FPTMC）。
分析两组之间是否存在：a）鉴别特征；和 b）预后差异。
Cox 回归分析和生存分析。
共纳入 94 例患者，44%（n=41）为单中心 FPTMC，56%（n=53）为多中心 FPTMC。两组在社会家庭、临床或组织学变量方面无差异。在 B 组中，更多地采用了更积极的治疗方法，全甲状腺切除术的频率更高（99%比 78%；p=0.003），淋巴结清扫术的频率更高（41%比 15%；p=0.005），放射性碘治疗的频率更高（96%比 73%；p=0.002）。两组肿瘤分期相似（p=0.237），B 组 T3 病例较多（24%比 5%；p=0.009）。平均随访 90±68.95 个月后，两组的肿瘤学结果相似，疾病持续率相似（9%比 5%；p=0.337），疾病复发率相似（21%比 8%；p=0.159），无疾病生存率相似（p=0.075）。
单中心 FPTMC 不应因其预后与多中心 FPTMC 相似而被视为 SPTMC。
