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Single-center study of familial papillary thyroid cancer in China: surgical considerations.

Lei S, Wang D, Ge J, Liu H, Zhao D, Li G, Ding Z - World J Surg Oncol (2015)

Bottom Line: Twenty-two patients (8.9%) with a positive family history were confirmed.Patients with FPTC had a predilection for female subjects and tended to be younger than other patients, but the difference was not significant (P = 0.0514 and P = 0.168).However, sufficient detailed interrogation and long-term follow-up of the patients and their family are necessary for providing individualized recommendations for clinical management.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Nanfang Hospital, No, 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. leishangtong@163.com.

ABSTRACT

Background: Whether familial papillary thyroid cancer (FPTC) is more aggressive than sporadic counterpart remains elusive, and the optimal clinical approach for FPTC is yet to be established. In this study, we investigated familial occurrence of PTC in China and reviewed our experience of its surgical treatment.

Methods: The clinical records of 248 consecutive patients with an established diagnosis of PTC who were admitted to Nanfang Hospital for thyroidectomy between January 2011 and June 2013 were analyzed in this study. Patients included 66 males and 182 females, aged 11 to 76 years.

Results: Twenty-two patients (8.9%) with a positive family history were confirmed. Patients with FPTC had a predilection for female subjects and tended to be younger than other patients, but the difference was not significant (P = 0.0514 and P = 0.168). They were more likely to present large tumors (P = 0.0024), multifocality (familial vs. sporadic: 54.50% vs. 26.50%; P < 0.006), local invasion (81.8% vs. 23.9%; P < 0.001), and malignant lymph nodes (63.6% vs. 33.6%; P = 0.005). Univariate and multivariate analyses identified that a positive family history was an independent risk factor for local invasion (OR: 5.683; 95% CI: 2.056 to 15.707; P = 0.001), malignant lymph nodes (OR: 3.005; 95% CI: 1.046 to 8.630; P = 0.041) in FPTC patients. Kaplan-Meier survival curves revealed that an aggressive surgical strategy was associated with a better relapse-free survival than conventional one (P = 0.032).

Conclusions: FPTC is more likely to possess aggressive features than sporadic counterparts. Thus, screening of at-risk families is essential to aid in earlier recognition. An aggressive surgical strategy appeared to be the more effective therapy. However, sufficient detailed interrogation and long-term follow-up of the patients and their family are necessary for providing individualized recommendations for clinical management.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier survival curves in FPTC patients grouped according to operation strategy. A better relapse-free survival was observed in FPTC patients in AG than CG (P = 0.032). AG: aggressive surgery group, CG: conventional surgery group.
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Fig1: Kaplan-Meier survival curves in FPTC patients grouped according to operation strategy. A better relapse-free survival was observed in FPTC patients in AG than CG (P = 0.032). AG: aggressive surgery group, CG: conventional surgery group.

Mentions: Because of the high rate of recurrence and lymphatic metastases seen in FPTC patients in the early period of this study and the association between reported appreciable death rate and recurrence, a more aggressive surgical strategy has been applied to treat FPTC since January 2012. Kaplan-Meier survival curves revealed that a more aggressive surgical strategy presented with a better relapse-free survival than conventional one (P = 0.032) (Figure 1).Figure 1


Single-center study of familial papillary thyroid cancer in China: surgical considerations.

Lei S, Wang D, Ge J, Liu H, Zhao D, Li G, Ding Z - World J Surg Oncol (2015)

Kaplan-Meier survival curves in FPTC patients grouped according to operation strategy. A better relapse-free survival was observed in FPTC patients in AG than CG (P = 0.032). AG: aggressive surgery group, CG: conventional surgery group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4374499&req=5

Fig1: Kaplan-Meier survival curves in FPTC patients grouped according to operation strategy. A better relapse-free survival was observed in FPTC patients in AG than CG (P = 0.032). AG: aggressive surgery group, CG: conventional surgery group.
Mentions: Because of the high rate of recurrence and lymphatic metastases seen in FPTC patients in the early period of this study and the association between reported appreciable death rate and recurrence, a more aggressive surgical strategy has been applied to treat FPTC since January 2012. Kaplan-Meier survival curves revealed that a more aggressive surgical strategy presented with a better relapse-free survival than conventional one (P = 0.032) (Figure 1).Figure 1

Bottom Line: Twenty-two patients (8.9%) with a positive family history were confirmed.Patients with FPTC had a predilection for female subjects and tended to be younger than other patients, but the difference was not significant (P = 0.0514 and P = 0.168).However, sufficient detailed interrogation and long-term follow-up of the patients and their family are necessary for providing individualized recommendations for clinical management.

View Article: PubMed Central - PubMed

Affiliation: Department of General Surgery, Nanfang Hospital, No, 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. leishangtong@163.com.

ABSTRACT

Background: Whether familial papillary thyroid cancer (FPTC) is more aggressive than sporadic counterpart remains elusive, and the optimal clinical approach for FPTC is yet to be established. In this study, we investigated familial occurrence of PTC in China and reviewed our experience of its surgical treatment.

Methods: The clinical records of 248 consecutive patients with an established diagnosis of PTC who were admitted to Nanfang Hospital for thyroidectomy between January 2011 and June 2013 were analyzed in this study. Patients included 66 males and 182 females, aged 11 to 76 years.

Results: Twenty-two patients (8.9%) with a positive family history were confirmed. Patients with FPTC had a predilection for female subjects and tended to be younger than other patients, but the difference was not significant (P = 0.0514 and P = 0.168). They were more likely to present large tumors (P = 0.0024), multifocality (familial vs. sporadic: 54.50% vs. 26.50%; P < 0.006), local invasion (81.8% vs. 23.9%; P < 0.001), and malignant lymph nodes (63.6% vs. 33.6%; P = 0.005). Univariate and multivariate analyses identified that a positive family history was an independent risk factor for local invasion (OR: 5.683; 95% CI: 2.056 to 15.707; P = 0.001), malignant lymph nodes (OR: 3.005; 95% CI: 1.046 to 8.630; P = 0.041) in FPTC patients. Kaplan-Meier survival curves revealed that an aggressive surgical strategy was associated with a better relapse-free survival than conventional one (P = 0.032).

Conclusions: FPTC is more likely to possess aggressive features than sporadic counterparts. Thus, screening of at-risk families is essential to aid in earlier recognition. An aggressive surgical strategy appeared to be the more effective therapy. However, sufficient detailed interrogation and long-term follow-up of the patients and their family are necessary for providing individualized recommendations for clinical management.

No MeSH data available.


Related in: MedlinePlus