Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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Clinical Characteristics of Pediatric & Adolescent Thyroid Cancer: A Single Institution Experience of 20 Years

소아청소년 갑상선암의 임상적 특징들: 단일 기관에서의 20년간의 연구

  • Moon, Ki Yoon (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, Kwangsoon (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Bae, Ja Seong (Department of Surgery, College of Medicine, The Catholic University of Korea) ;
  • Kim, Jeong Soo (Department of Surgery, College of Medicine, The Catholic University of Korea)
  • 문기윤 (가톨릭대학교 서울성모병원 외과) ;
  • 김광순 (가톨릭대학교 서울성모병원 외과) ;
  • 배자성 (가톨릭대학교 서울성모병원 외과) ;
  • 김정수 (가톨릭대학교 서울성모병원 외과)
  • Received : 2020.05.27
  • Accepted : 2020.09.07
  • Published : 2020.11.30
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Abstract

Background/Objectives: Pediatric & Adolescent thyroid cancer is a steadily increasing malignancy. We aimed to report our experience at a single tertiary institution and to evaluate the risk factors for recurrence in pediatric & adolescent patients with differentiated thyroid carcinoma (DTC). Materials & Methods: The data of 42 pediatric & adolescent patients (aged ≤19 years) with DTC who underwent thyroidectomy at Seoul St. Mary's Hospital (Seoul, Korea) between December 1997 and February 2019 were retrospectively reviewed. Clinicopathologic features and surgical outcomes were retrospectively analyzed through complete chart reviews. Results: The mean age was 16.6 years. A total of 6 (14.3%) patients experienced recurrence after initial treatment. The recurrence rate was significantly different between total thyroidectomy (TT) and lobectomy groups (23.1% vs. 0%, p=0.038). However, no statistically significant differences were found in the recurrence rate according to lymph node ratio (LNR) of 0.4 (10.7% vs 21.4%; P=0.383). Multivariate analysis confirmed age (hazard ratio [HR], 0.443; P=0.008) and bilaterality (HR, 11.477; P=0.022) as significant risk factors for DFS. Conclusion: Pediatric & Adolescent thyroid cancer is a rare malignancy and TT is recommended as the treatment of choice. However, lobectomy may be considered for Pediatric & Adolescent patients with age >16 years, tumor size <1 cm, and no bilateral disease.

Keywords

References

  1. Qian ZJ, Jin MC, Meister KD, Megwalu UC. Pediatric Thyroid Cancer Incidence and Mortality Trends in the United States, 1973-2013. JAMA Otolaryngol Head Neck Surg. 2019;145:617-623. https://doi.org/10.1001/jamaoto.2019.0898
  2. Bernier MO, Withrow DR, Berrington de Gonzalez A, Lam CJK, Linet MS, Kitahara CM, et al. Trends in pediatric thyroid cancer incidence in the United States, 1998-2013. Cancer. 2019;125:2497-2505. https://doi.org/10.1002/cncr.32125
  3. Dermody S, Walls A, Harley EH, Jr. Pediatric thyroid cancer: An update from the SEER database 2007-2012. Int J Pediatr Otorhinolaryngol. 2016;89:121-126. https://doi.org/10.1016/j.ijporl.2016.08.005
  4. Cho YY, Jang HW, Joung JY, Park SM, Jeong DJ, Kim SW, et al. Trends in Thyroid Cancer Incidence in Korean Children (1999-2012) Based on Palpation and Nonpalpation Detection Methods. Eur Thyroid J. 2015;4:252-259. https://doi.org/10.1159/000442047
  5. Francis GL, Waguespack SG, Bauer AJ, Angelos P, Benvenga S, Cerutti JM, et al. Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2015;25:716-759. https://doi.org/10.1089/thy.2014.0460
  6. Chaukar DA, Rangarajan V, Nair N, Dcruz AK, Nadkarni MS, Pai PS, et al. Pediatric thyroid cancer. J Surg Oncol. 2005;92:130-133. https://doi.org/10.1002/jso.20339
  7. Welch Dinauer CA, Tuttle RM, Robie DK, McClellan DR, Svec RL, Adair C, et al. Clinical features associated with metastasis and recurrence of differentiated thyroid cancer in children, adolescents and young adults. Clin Endocrinol (Oxf). 1998;49:619-628. https://doi.org/10.1046/j.1365-2265.1998.00584.x
  8. Dinauer C, Francis GL. Thyroid cancer in children. Endocrinol Metab Clin North Am. 2007;36:779-806, vii. https://doi.org/10.1016/j.ecl.2007.04.002
  9. Holmes L, Jr., Hossain J, Opara F. Pediatric thyroid carcinoma incidence and temporal trends in the USA (1973-2007): race or shifting diagnostic paradigm? ISRN Oncol. 2012;2012:906197. https://doi.org/10.5402/2012/906197
  10. Demidch ik YE, Demidch ik EP, R einers C, Biko J , Mine M, Saenko VA, et al. Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus. Ann Surg. 2006;243:525. https://doi.org/10.1097/01.sla.0000205977.74806.0b
  11. Enomoto Y, Enomoto K, Uchino S, Shibuya H, Watanabe S, Noguchi S. Clinical features, treatment, and long-term outcome of papillary thyroid cancer in children and adolescents without radiation exposure. World J Surg. 2012;36:1241-1246. https://doi.org/10.1007/s00268-012-1558-4
  12. Huang CH, Chao TC, Hseuh C, Lin KJ, Ho TY, Lin SF, et al. Therapeutic outcome and prognosis in young patients with papillary and follicular thyroid cancer. Pediatr Surg Int. 2012;28:489-494. https://doi.org/10.1007/s00383-012-3054-1
  13. Park S, Jeong JS, Ryu HR, Lee CR, Park JH, Kang SW, et al. Differentiated thyroid carcinoma of children and adolescents: 27-year experience in the yonsei university health system. J Korean Med Sci. 2013;28:693-699. https://doi.org/10.3346/jkms.2013.28.5.693
  14. Pires BP, Alves PA, Jr., Bordallo MA, Bulzico DA, Lopes FP, Farias T, et al. Prognostic Factors for Early and Long-Term Remission in Pediatric Differentiated Thyroid Carcinoma: The Role of Sex, Age, Clinical Presentation, and the Newly Proposed American Thyroid Association Risk Stratification System. Thyroid. 2016;26:1480-1487. https://doi.org/10.1089/thy.2016.0302
  15. Hay ID, Gonzalez-Losada T, Reinalda MS, Honetschlager JA, Richards ML, Thompson GB. Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008. World J Surg. 2010;34:1192-1202. https://doi.org/10.1007/s00268-009-0364-0
  16. Mao XC, Yu WQ, Shang JB, Wang KJ. Clinical characteristics and treatment of thyroid cancer in children and adolescents: a retrospective analysis of 83 patients. J Zhejiang Univ Sci B. 2017;18:430-436.
  17. Gow KW, Lensing S, Hill DA, Krasin MJ, McCarville MB, Rai SN, et al. Thyroid carcinoma presenting in childhood or after treatment of childhood malignancies: An institutional experience and review of the literature. J Pediatr Surg. 2003;38:1574-1580. https://doi.org/10.1016/S0022-3468(03)00563-3
  18. Demidch ik YE, Demidch ik EP, R einers C, Biko J , Mine M, Saenko VA, et al. Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus. Ann Surg. 2006;243:525-532. https://doi.org/10.1097/01.sla.0000205977.74806.0b
  19. Amit M, Tam S, Boonsripitayanon M, Cabanillas ME, Busaidy NL, Grubbs EG, et al. Association of Lymph Node Density With Survival of Patients With Papillary Thyroid Cancer. JAMA Otolaryngol Head Neck Surg. 2018;144:108-114. https://doi.org/10.1001/jamaoto.2017.2416
  20. Rubinstein JC, Dinauer C, Herrick-Reynolds K, Morotti R, Callender GG, Christison-Lagay ER. Lymph node ratio predicts recurrence in pediatric papillary thyroid cancer. J Pediatr Surg. 2019;54:129-132. https://doi.org/10.1016/j.jpedsurg.2018.10.010
  21. Wang C, Chen X, Wei X, Chen F, Wang Y, Shen Z. Recurrence factors and prevention of complications of pediatric differentiated thyroid cancer. Asian J Surg. 2017;40:55-60. https://doi.org/10.1016/j.asjsur.2016.09.001
  22. Kim J, Sun Z, Adam MA, Adibe OO, Rice HE, Roman SA, et al. Predictors of nodal metastasis in pediatric differentiated thyroid cancer. J Pediatr Surg. 2017;52:120-123. https://doi.org/10.1016/j.jpedsurg.2016.10.033
  23. Balachandar S, La Quaglia M, Tuttle RM, Heller G, Ghossein RA, Sklar CA. Pediatric Differentiated Thyroid Carcinoma of Follicular Cell Origin: Prognostic Significance of Histologic Subtypes. Thyroid. 2016;26:219-226. https://doi.org/10.1089/thy.2015.0287
  24. Jeon MJ, Kim YN, Sung TY, Hong SJ, Cho YY, Kim TY, et al. Practical Initial Risk Stratification Based on Lymph Node Metastases in Pediatric and Adolescent Differentiated Thyroid Cancer. Thyroid. 2018;28:193-200. https://doi.org/10.1089/thy.2017.0214