Differences in the aggressiveness of familial versus sporadic non-medullary thyroid cancer: An unresolved controversy.
Familial non-medullary thyroid cancer (FNMTC) is defined as non-medullary thyroid cancer occurring in two or more first-degree relatives, without features of known hereditary syndromes. Although familial predisposition is well established, its clinical behavior remains debated. This study aimed at characterizing familial cases compared to sporadic non-medullary thyroid cancer (SNMTC).
FNMTC and SNMTC patients were recruited from the Endocrine Division (SEMPR) of the Federal University of Paraná, Brazil, and private endocrine clinics in Curitiba, Paraná, Brazil (2000-2019). Baseline, histopathological, and clinical data were analyzed using SPSS Statistics 26.0. Statistical comparisons employed chi-square, Student's t test, and Mann-Whitney U test, as appropriate. Post hoc power analysis was performed using G*Power 3.1.9.7, and R 2025.05.0.
We analyzed 39 FNMTC and 119 SNMTC patients. Papillary thyroid carcinoma was the predominant histological type in both groups. FNMTC patients were diagnosed at a younger age (38.5 ± 14.2 vs. 46.6 ± 13.8 years, p = 0.003) and more frequently presented with lymph node metastases at diagnosis (46.2% vs. 21.8%, p = 0.007), with a 4.57-fold increased risk. Despite these differences, long-term outcomes did not differ significantly between groups. An earlier disease onset in subsequent generation suggests a possible anticipation phenomenon.
These findings suggest that FNMTC patients may present with earlier onset and higher rates of lymph node involvement, underscoring the need for thorough preoperative lateral neck evaluation. In view of a possible anticipation phenomenon, cervical ultrasound screening might be considered starting in adolescence.
FNMTC and SNMTC patients were recruited from the Endocrine Division (SEMPR) of the Federal University of Paraná, Brazil, and private endocrine clinics in Curitiba, Paraná, Brazil (2000-2019). Baseline, histopathological, and clinical data were analyzed using SPSS Statistics 26.0. Statistical comparisons employed chi-square, Student's t test, and Mann-Whitney U test, as appropriate. Post hoc power analysis was performed using G*Power 3.1.9.7, and R 2025.05.0.
We analyzed 39 FNMTC and 119 SNMTC patients. Papillary thyroid carcinoma was the predominant histological type in both groups. FNMTC patients were diagnosed at a younger age (38.5 ± 14.2 vs. 46.6 ± 13.8 years, p = 0.003) and more frequently presented with lymph node metastases at diagnosis (46.2% vs. 21.8%, p = 0.007), with a 4.57-fold increased risk. Despite these differences, long-term outcomes did not differ significantly between groups. An earlier disease onset in subsequent generation suggests a possible anticipation phenomenon.
These findings suggest that FNMTC patients may present with earlier onset and higher rates of lymph node involvement, underscoring the need for thorough preoperative lateral neck evaluation. In view of a possible anticipation phenomenon, cervical ultrasound screening might be considered starting in adolescence.
Authors
Miasaki Miasaki, Cavalcanti Cavalcanti, Graf Graf, Kimura Kimura, Kopp Kopp, Carvalho Carvalho
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