Is familial non-medullary thyroid carcinoma more aggressive than sporadic thyroid cancer? A multicenter series

Background. The aggressiveness of familial non-medullary thyroid cancer (FN MTC) has been a subject of debate. The purpose of the study was to determin e whether FNMTC is more aggressive than sporadic thyroid cancer Methods. A multicenter retrospective matched-case control study of FNMTC ve rsus sporadic non-medullary thyroid cancer was conducted. Disease-free surv ival (time to recurrence)for both groups was compared. Results. Forty-eight familial cases were compared with 144 age-, gender-, a nd 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 w ho were from families with more than 2 thyroid cancer-affected members, had the worst prognosis. The available staging systems were less likely to pre dict the outcome in patients with FNMTC than in patients with sporadic non- medullary thyroid cancer unless one accounted for the strength of family hi s tory in the staging system. Conclusions. FNMTC is more aggressive than sporadic non-medullary thyroid c ancer 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.