Clinical Thyroidology / Research Article

Liu Y.a· Wang S.a· Li Y.a· Zhang X.a· Liu Z.a· Liu Q.a· Sun N.a· Zhang J.a· Ge W.a· Guo Y.b· Liu Y.a· Fang X.a· Ji T.a· Tai J.c· Ni X.a,b

Author affiliations

aDepartment of Otolaryngology, Head and Neck Surgery, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health (NCCH), Beijing, China
bBeijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Pediatric Research Institute, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health (NCCH), Beijing, China
cChildren’s Hospital Capital Institute of Pediatrics, Department of Otolaryngology, Head and Neck Surgery, Beijing, China

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Article / Publication Details

First-Page Preview

Received: December 21, 2020
Accepted: April 08, 2021
Published online: June 17, 2021

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 5

ISSN: 2235-0640 (Print)
eISSN: 2235-0802 (Online)

For additional information: https://www.karger.com/ETJ

Abstract

Objectives: The objectives of this study were to explore the clinical heterogeneity of differentiated thyroid cancer (DTC) between prepubertal children and adolescents and guide clinical treatment. Methods: A retrospective study included patients with DTC aged ≤19 years in Beijing Children’s Hospital from June 2014 to June 2019. All patients were enrolled and divided into 2 subgroups based on the threshold age of 10 years, namely the childhood group (CG) (≤10 years old); and the adolescent group (AG) (between 10 and 19 years old). The χ2 test and Fisher’s exact test were used to estimate the effect of risk factors in the 2 age groups. Multivariate binary logistic regression models were conducted to assess the recurrent risk factors. Results: Seventy cases of DTC were included with an average age of 9.94 ± 2.88 years, including 35 in CG and 35 in AG. The most common clinical manifestation was a painless mass in the neck, accounting for 77.1% (54/70) of patients. Compared with the AG, the CG was more likely to have lymph node metastasis (p = 0.022) and distant metastasis (p = 0.041). The CG was more likely to have extrathyroidal extension (p = 0.012) and had a significantly higher recurrence rate than the AG (p = 0.040). Age was an independent variable predictive of recurrence (p = 0.0347). Conclusion: Regional invasiveness, cervical lymph node metastasis, and distant metastasis of DTC were more likely to occur in children ≤10 years old. Meanwhile, children ≤10 years old with DTC were more likely to have recurrence than adolescent’s postsurgical treatment. Thus, children younger than 10 years of age with DTC should be treated more aggressively.

© 2021 European Thyroid Association Published by S. Karger AG, Basel

References Yang L, Zheng R, Wang N, Zhang S, Chen W. (Analysis of incidence and mortality of thyroid cancer in China, 2010). Zhonghua Yu Fang Yi Xue Za Zhi. 2014;48(8):663–8. Hogan AR, Zhuge Y, Perez EA, Koniaris LG, Lew JI, Sola JE. Pediatric thyroid carcinoma: incidence and outcomes in 1,753 patients. J Surg Res. 2009;156(1):167–72. Pellegriti G, Frasca F, Regalbuto C, Squatrito S, Vigneri R. Worldwide increasing incidence of thyroid cancer: update on epidemiology and risk factors. J Cancer Epidemiol. 2013;2013:965212. 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(7):617–23. Wang JL, Ren XY, Ni X, Tai J, Gong CX. (Clinical analysis of thyroid cancer in 62 children). Zhonghua Er Ke Za Zhi. 2018;56(8):597–600. Hung W, Sarlis NJ. Current controversies in the management of pediatric patients with well-differentiated nonmedullary thyroid cancer: a review. Thyroid. 2002;12(8):683. Shah S, Boucai L. Effect of age on response to therapy and mortality in patients with thyroid cancer at high risk of recurrence. J Clin Endocrinol Metab. 2018;103(2):689–97. Rubinstein JC, Herrick-Reynolds K, Dinauer C, Morotti R, Solomon D, Callender GG, et al. Recurrence and complications in pediatric and adolescent papillary thyroid cancer in a high-volume practice. J Surg Res. 2020;249:58–66. Jain NK, Mostoufi-Moab S, Hawkes CP, Nelson ND, Surrey LF, Jones ZS, et al. Extrathyroidal extension is an important predictor of regional lymph node metastasis in pediatric differentiated thyroid cancer. Thyroid. 2020 Jul;30(7):1037–43. Global World Health Organisation. Accelerated Action for the Health of Adolescents (AA-HA): guidance to support country implementation. Geneva; 2017. Kamran SC, Marqusee E, Kim MI, Frates MC, Ritner J, Peters H, et al. Thyroid nodule size and prediction of cancer. J Clin Endocrinol Metab. 2013;98(2):564–70. Rivkees SA, Mazzaferri EL, Verburg FA, Reiners C, Luster M, Breuer CK, et al. The treatment of differentiated thyroid cancer in children: emphasis on surgical approach and radioactive iodine therapy. Endocr Rev. 2011;32(6):798–826. Pazaitou-Panayiotou K, Iliadou PK, Mandanas S, Vasileiadis T, Mitsakis P, Tziomalos K, et al. Papillary thyroid carcinomas in patients under 21 years of age: clinical and histologic characteristics of tumors ≤10 mm. J Pediatr. 2015;166(2):451–6. Farahati J, Reiners C, Demidchik EP. Is the UICC/AJCC classification of primary tumor in childhood thyroid carcinoma valid? J Nucl Med. 1999;40(12):2125. Galuppini F, Vianello F, Censi S, Barollo S, Bertazza L, Carducci S, et al. Differentiated thyroid carcinoma in pediatric age: genetic and clinical scenario. Front Endocrinol. 2019;10:552. Spinelli C, Tognetti F, Strambi S, Morganti R, Massimino M, Collini P. Cervical lymph node metastases of papillary thyroid carcinoma, in the central and lateral compartments, in children and adolescents: predictive factors children and adolescents: predictive factors. World J Surg. 2018;42(8):2444–53. Vaisman F, Bulzico DA, Pessoa CH, Bordallo MA, Mendonça UB, Dias FL, et al. Prognostic factors of a good response to initial therapy in children and adolescents with differentiated thyroid cancer. Clinics. 2011;66(2):281–6. Zimmerman D, Hay ID, Gough IR, Goellner JR, Ryan JJ, Grant CS, et al. Papillary thyroid carcinoma in children and adults: long-term follow-up of 1,039 patients conservatively treated at one institution during three decades. Surgery. 1988;104(6):1157. Jin YQ, Wang SC, Tai J, Zhang J, Chen F, Shi J, et al. (The difference expression and diagnostic value of RPL5 in papillary thyroid carcinoma of children and adults). Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017;52(11):830–4. Jin YQ, Feng L, Chu P, Zhang J, Tai J, Han Y, et al. Expression and diagnostic value of KDM4A in papillary thyroid carcinoma of children and adults. J Chin.Oncol. 2016;22(10):838–43. Cordioli MI, Moraes L, Alves MT, Delcelo R, Monte O, Longui CA, et al. Thyroid-specific genes expression uncovered age-related differences in pediatric thyroid carcinomas. Int J Endocrinol. 2016;2016:1956740–9. Handkiewicz-Junak D, Wloch J, Roskosz J, Krajewska J, Kropinska A, Pomorski L, et al. Total thyroidectomy and adjuvant radioiodine treatment independently decrease locoregional recurrence risk in childhood and adolescent differentiated thyroid cancer. J Nucl Med. 2007;48(6):879–88. Jarzab B, Handkiewicz Junak D, Włoch J, Kalemba B, Roskosz J, Kukulska A, et al. Multivariate analysis of prognostic factors for differentiated thyroid carcinoma in children. Eur J Nucl Med. 2000;27(7):833–41. 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(6):1192–202. Scholz S, Smith JR, Chaignaud B, Shamberger RC, Huang SA, et al. Thyroid surgery at children’s hospital Boston: a 35-year single-institution experience. J Pediatr Surg. 2011;46(3):437–42. Sugino K, Nagahama M, Kitagawa W, Shibuya H, Ohkuwa K, Uruno T, et al. Papillary thyroid carcinoma in children and adolescents: long-term follow-up and clinical characteristics. World J Surg. 2015;39(9):2259–65. Astl J, Chovanec M, Lukeš P, Katra R, Dvořáková M, Vlček P, et al. Thyroid carcinoma surgery in children and adolescents – 15 years experience surgery of pediatric thyroid carcinoma. Int J Pediatr Otorhinolaryngol. 2014;78(7):990–4. Demidchik YE, Demidchik EP, Reiners 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(4):525–32. 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(7):716–59. van Santen HM, Aronson DC, Vulsma T, Tummers RF, Geenen MM, de Vijlder JJ, et al. Frequent adverse events after treatment for childhood-onset differentiated thyroid carcinoma: a single institute experience. Eur J Cancer. 2004;40(11):1743–51. Giordano D, Valcavi R, Thompson GB, Pedroni C, Renna L, Gradoni P, et al. Complications of central neck dissection in patients with papillary thyroid carcinoma: results of a study on 1,087 patients and review of the literature. Thyroid. 2012;22(9):911–7. Baumgarten HD, Bauer AJ, Isaza A, Mostoufi-Moab S, Kazahaya K, Adzick NS, et al. Surgical management of pediatric thyroid disease: complication rates after thyroidectomy at the children’s hospital of philadelphia high-volume pediatric thyroid center. J Pediatr Surg. 2019;54(10):1969. Alkhars A, Abouzayd M, Rouf C, Lardy H, Bakhos D, Pondaven-Letourmy S, et al. Pediatric thyroid surgery: experience in 75 consecutive thyroidectomies. Eur Arch Otorhinolaryngol. 2019;276(1):217–22. Bussières V, Roy S, Deladoey J, Rousseau É, St-Vil D, Piché N, et al. Pediatric thyroidectomy: Favorable outcomes can be achieved by a multidisciplinary team of pediatric providers. J Pediatr Surg. 2019 Mar;54(3):527–30. Loyo M, Tufano RP, Gourin CG. National trends in thyroid surgery and the effect of volume on short-term outcomes. Laryngoscope. 2013;123(8):2056–63. Article / Publication Details

First-Page Preview

Received: December 21, 2020
Accepted: April 08, 2021
Published online: June 17, 2021

Number of Print Pages: 8
Number of Figures: 0
Number of Tables: 5

ISSN: 2235-0640 (Print)
eISSN: 2235-0802 (Online)

For additional information: https://www.karger.com/ETJ

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