Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Presentation and Clinical Outcome between Children and Young Adults with Differentiated Thyroid Cancer

  • Wang, Jian-Tao (Nuclear Medicine department of West China Hospital) ;
  • Huang, Rui (Nuclear Medicine department of West China Hospital) ;
  • Kuang, An-Ren (Nuclear Medicine department of West China Hospital)
  • Published : 2014.09.15
Download PDF
⟨ Previous Next ⟩

Abstract

Background: The aim of the present study was to evaluate the presentation, clinical course and outcome between children and young adults with differentiated thyroid cancer (DTC) treated in our hospital. Materials and Methods: The medical records of 145 patients with DTC who underwent surgery followed by radioiodine and thyroid hormone (TSH) suppression were retrospectively reviewed. The follow up was between January 2006 and June 2012. These patients consisted of 38 children (age${\leq}18y$) and 107 young adult patients (age${\leq}30y$). The clinical characteristics and outcome were analyzed and compared, and the progression-free survival (PFS) was evaluated using the Kaplan-Meier method. Results: At initial diagnosis, a greater degree of extra thyroidal extension was found in children than adults patients (p<0.001). However, there was no significant difference between the two groups with regard to the tumor size and the presence of lymph node or distant metastasis (p=0.172, p=0.050 and p=0.068, respectively). The extent of surgery and the cumulative or mean dose of radioiodine were similar in both groups. During the follow up, the overall survival rate was 100% for both groups, and the PFS rate was similar in children and in young adults group (log rank test, ${\chi}^2$=0.126, p=0.723). Conclusions: In comparison to the young adult patients, DTC in children presents with more aggressive behavior, but outcomes are similar between the two groups after the intensive management of surgery followed by radioiodine and TSH suppression therapy.

Keywords

References

  1. Adeniran A, Zhu Z, Gandhi M, et al (2006). Correlation between genetic alterations and microscopic features, clinical manifestations, and prognostic characteristics of thyroid papillary carcinomas. Am J Surg Pathol, 30, 216-22. https://doi.org/10.1097/01.pas.0000176432.73455.1b
  2. Agac A, Kutun S, cetin A (2013). Are the characteristics of thyroid cancer different in young patients? J Pediatr Endocrinol Metab, 27,497-502.
  3. Cooper D, Doherty G, Haugen B, et al (2009). Revised american thyroid association management guidelines for patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer. Thyroid, 19, 1167-214.
  4. Davies L, Welch H (2014). Current Thyroid Cancer Trends in the United States. JAMA Otolaryngol Head Neck Surg, 140, 317-22. https://doi.org/10.1001/jamaoto.2014.1
  5. Danese D, Gardini A, Farsetti A, et al (1997). Thyroid carcinoma in children and adolescents. Eur J Pediatr, 156, 190-4. https://doi.org/10.1007/s004310050580
  6. Degroot L, Kaplan E, McCormick M, et al (1990). Natural history, treatment, and course of papillary thyroid carcinoma. J Clin Endocrinol Metab, 71, 414-24. https://doi.org/10.1210/jcem-71-2-414
  7. Faggiano A, Coulot J, Bellon N, et al (2004). Age-dependent variation of follicular size and expression of iodine transporters in human thyroid tissue. J Nucl Med, 45, 232-7.
  8. Farahati J, Reiners C, Demidchik E (1999). Is the UICC/AJCC classification of primary tumor in childhood thyroid carcinoma valid? J Nucl Med, 40, 2125.
  9. Frankenthaler R, Sellin R, Cangir A, et al (1990). Lymph node metastasis from papillary-follicular thyroid carcinoma in young patients. Am J Surg, 160, 341-3. https://doi.org/10.1016/S0002-9610(05)80538-0
  10. Gulcelik M, Kuru B, Dincer H, et al (2012). Complications of completion versus total thyroidectomy. Asian Pac J Cancer Prev, 13, 5225-8. https://doi.org/10.7314/APJCP.2012.13.10.5225
  11. Handkiewicz-Junak D, Wloch J, Roskosz J, et al (2007). Total thyroidectomy and adjuvant radioiodine treatment independently decrease locoregional recurrence risk in childhood and adolescent differentiated thyroid cancer. J Nucl Med, 48, 879-88. https://doi.org/10.2967/jnumed.106.035535
  12. Hovens G, Stokkel M, Kievit J, et al (2007). Associations of serum thyrotropin concentrations with recurrence and death in differentiated thyroid cancer. J Clin Endocrinol Metab, 92, 2610-5. https://doi.org/10.1210/jc.2006-2566
  13. Kim SS, Kim SJ, Kim IJ, et al (2012). Comparison of clinical outcomes in differentiated thyroid carcinoma between children and young adult patients. Clin Nucl Med, 37, 850-3. https://doi.org/10.1097/RLU.0b013e318262c5d6
  14. Lazar L, Lebenthal Y, Steinmetz A, et al (2009). Differentiated thyroid carcinoma in pediatric patients: comparison of presentation and course between pre-pubertal children and adolescents. J Pediatr, 154, 708-14. https://doi.org/10.1016/j.jpeds.2008.11.059
  15. Lima J, Trovisco V, Soares P, et al (2004). BRAF mutations are not a major event in post-Chernobyl childhood thyroid carcinomas. J Clin Endocrinol Metab, 89, 4267-71. https://doi.org/10.1210/jc.2003-032224
  16. Lupi C, Giannini R, Ugolini C, et al (2007). Association of BRAF V600E mutation with poor clinicopathological outcomes in 500 consecutive cases of papillary thyroid carcinoma. J Clin Endocrinol Metab, 92, 4085-90. https://doi.org/10.1210/jc.2007-1179
  17. Mehta V, Nikiforov Y, Ferris R (2013). Use of molecular biomarkers in FNA specimens to personalize treatment for thyroid surgery. Head Neck. 35, 1499-506.
  18. Miller R, L Young J, Novakovic B (1995). Childhood cancer. Cancer, 75, 395-405. https://doi.org/10.1002/1097-0142(19950101)75:1+<395::AID-CNCR2820751321>3.0.CO;2-W
  19. Patel A, Jhiang S, Dogra S, et al (2002). Differentiated thyroid carcinoma that express sodium-iodide symporter have a lower risk of recurrence for children and adolescents. Pediatr Res, 52, 737-44. https://doi.org/10.1203/00006450-200211000-00021
  20. Riesco G, Gutierrez P, Garcia M, et al (2006). The oncogene BRAFV600E is associated with a high risk of recurrence and less differentiated papillary thyroid carcinoma due to the impairment of Na+/I- targeting to the membrane. Endocr relat cancer, 13, 257-69. https://doi.org/10.1677/erc.1.01119
  21. Ringel M, Anderson J, Souza S, et al (2001). Expression of the sodium iodide symporter and thyroglobulin genes are reduced in papillary thyroid cancer. Mod Pathol, 14, 289-96. https://doi.org/10.1038/modpathol.3880305
  22. Yu WB, Tao SY, Zhang NS (2012). Is level V dissection necessary for low-risk patients with papillary thyroid cancer metastasis in lateral neck levels II, III, and IV. Asian Pac J Cancer Prev, 13, 4619-22. https://doi.org/10.7314/APJCP.2012.13.9.4619
  23. Zaman MU, Fatima N, Padhy AK, et al (2013).Controversies about radioactive iodine-131 remnant ablation in low risk thyroid cancers: are we near a consensus? Asian Pac J Cancer Prev, 14, 6209-13. https://doi.org/10.7314/APJCP.2013.14.11.6209

Cited by

  1. MiR-99a Inhibits Cell Proliferation and Tumorigenesis through Targeting mTOR in Human Anaplastic Thyroid Cancer vol.16, pp.12, 2015, https://doi.org/10.7314/APJCP.2015.16.12.4937
  2. Comparison of differentiated thyroid cancer in children and adolescents (≤20 years) with young adults vol.84, pp.4, 2015, https://doi.org/10.1111/cen.12845
  3. Classical V600E and other non-hotspot BRAF mutations in adult differentiated thyroid cancer vol.14, pp.1, 2016, https://doi.org/10.1186/s12967-016-0958-x
  4. Single Point Mutations in Pediatric Differentiated Thyroid Cancer vol.27, pp.2, 2017, https://doi.org/10.1089/thy.2016.0339
  5. Initial Treatment Patterns in Younger Adult Patients with Differentiated Thyroid Cancer in California vol.25, pp.5, 2015, https://doi.org/10.1089/thy.2014.0610
  6. Promoter Mutations in Pediatric Thyroid Cancer vol.26, pp.2, 2016, https://doi.org/10.1089/thy.2015.0510