title: Single-center study of familial papillary thyroid cancer in China: surgical considerations.
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.
authors.affiliation: Department of General Surgery, Nanfang Hospital, No, 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. leishangtong@163.com.
authors.forename: Shangtong
authors.initials: S
authors.lastname: Lei
authors.affiliation: Department of General Surgery, Nanfang Hospital, No, 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. wonder0618.dw@gmail.com.
authors.forename: Da
authors.initials: D
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Nanfang Hospital, No, 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. 2053196573@qq.com.
authors.forename: Junna
authors.initials: J
authors.lastname: Ge
authors.affiliation: Department of General Surgery, Nanfang Hospital, No, 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. 1697960280@qq.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of General Surgery, Nanfang Hospital, No, 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. 505176434@qq.com.
authors.forename: Donghui
authors.initials: D
authors.lastname: Zhao
authors.affiliation: Department of General Surgery, Nanfang Hospital, No, 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. gzliguoxin@163.com.|Anatomical Institute of Minimally Invasive Surgery, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. gzliguoxin@163.com.
authors.forename: Guoxin
authors.initials: G
authors.lastname: Li
authors.affiliation: Anatomical Institute of Minimally Invasive Surgery, Southern Medical University, No. 1838 North Guangzhou Avenue, Guangzhou, 510515, Guangdong, China. wangda.0618@aliyun.com.
authors.forename: Zihai
authors.initials: Z
authors.lastname: Ding
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002291:Carcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D002648:Child; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D055815:Young Adult