Is familial non-medullary thyroid carcinoma more aggressive than sporadic thyroid cancer? A multicenter series.
BACKGROUND
The aggressiveness of familial non-medullary thyroid cancer (FNMTC) has been a subject of debate. The purpose of the study was to determine whether FNMTC is more aggressive than sporadic thyroid cancer.


METHODS
A multicenter retrospective matched-case control study of FNMTC versus sporadic non-medullary thyroid cancer was conducted. Disease-free survival (time to recurrence) for both groups was compared.


RESULTS
Forty-eight familial cases were compared with 144 age-, gender-, and stage-matched controls. Patients with FNMTC had a significantly shorter disease-free survival compared with sporadic non medullary thyroid cancer. Patients with FNMTC who presented with evidence of distant metastasis, or who were from families with more than 2 thyroid cancer-affected members, had the worst prognosis. The available staging systems were less likely to predict the outcome in patients with FNMTC than in patients with sporadic non-medullary thyroid cancer unless one accounted for the strength of family history in the staging system.


CONCLUSIONS
FNMTC is more aggressive than sporadic non-medullary thyroid cancer. The best predictors of a poor outcome in patients with FNMTC are the number of family members affected by thyroid cancer and evidence of distant metastasis.
Alsanea
O
O
Department of Surgery, University of California, San Francisco, 94143-1674, USA.
Wada
N
N
Ain
K
K
Wong
M
M
Taylor
K
K
Ituarte
P H
PH
Treseler
P A
PA
Weier
H U
HU
Freimer
N
N
Siperstein
A E
AE
Duh
Q Y
QY
Takami
H
H
Clark
O H
OH
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome