TY - JOUR
T1 - Differentiated thyroid cancer in children and adolescents
T2 - Long term outcome and risk factors for persistent disease
AU - Sapuppo, Giulia
AU - Hartl, Dana
AU - Fresneau, Brice
AU - Hadoux, Julien
AU - Breuskin, Ingrid
AU - Baudin, Eric
AU - Rigaud, Charlotte
AU - Guerlain, Joanne
AU - Ghuzlan, Abir Al
AU - Leboulleux, Sophie
AU - Schlumberger, Martin
AU - Lamartina, Livia
N1 - Publisher Copyright:
© 2021 by the authors.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Background: Pediatric differentiated thyroid cancer (P-DTC) frequently presents with advanced disease. The study aim was to evaluate the outcome of P-DTC and a modified 2015 American Thyroid Association risk classification (ATA-R). Methods: A retrospective study of consecutive P-DTC patients was performed. The ATA-R for P-DTC was used with a cut-off of ≤ 5 N1a for low-risk. The outcome could be excellent response (ER) (thyroglobulin < 1 ng/mL and no evidence of disease (EoD) at imaging), biochemical incomplete response (BIR) (thyroglobulin ≥ 1 ng/mL and no EoD at imaging) or structural incomplete response (SIR) (EoD at imaging). Results: We studied 260 P-DTC (70% females; median age at diagnosis 14 years; 93% total thyroidectomy and 82% lymph node dissection). The ATA-R was low in 30% cases, intermediate in 15% and high in 55%, including 31.5% with distant metastases. Radioiodine treatment was administered in 218 (83.8%), and further radioiodine and surgery was performed in 113 (52%) and 76 (29%) patients, respectively. After a median follow-up of 8.2 years, the outcome was ER in 193 (74.3%), BIR in 17 (6.5%) and SIR in 50 (19.2%). Independent predictors of SIR or BIR at first and last visits were ATA-R intermediate or high. Conclusion: P-DTC has an excellent prognosis. Modified ATA-R is a useful prognostic tool in P-DTC to guide management.
AB - Background: Pediatric differentiated thyroid cancer (P-DTC) frequently presents with advanced disease. The study aim was to evaluate the outcome of P-DTC and a modified 2015 American Thyroid Association risk classification (ATA-R). Methods: A retrospective study of consecutive P-DTC patients was performed. The ATA-R for P-DTC was used with a cut-off of ≤ 5 N1a for low-risk. The outcome could be excellent response (ER) (thyroglobulin < 1 ng/mL and no evidence of disease (EoD) at imaging), biochemical incomplete response (BIR) (thyroglobulin ≥ 1 ng/mL and no EoD at imaging) or structural incomplete response (SIR) (EoD at imaging). Results: We studied 260 P-DTC (70% females; median age at diagnosis 14 years; 93% total thyroidectomy and 82% lymph node dissection). The ATA-R was low in 30% cases, intermediate in 15% and high in 55%, including 31.5% with distant metastases. Radioiodine treatment was administered in 218 (83.8%), and further radioiodine and surgery was performed in 113 (52%) and 76 (29%) patients, respectively. After a median follow-up of 8.2 years, the outcome was ER in 193 (74.3%), BIR in 17 (6.5%) and SIR in 50 (19.2%). Independent predictors of SIR or BIR at first and last visits were ATA-R intermediate or high. Conclusion: P-DTC has an excellent prognosis. Modified ATA-R is a useful prognostic tool in P-DTC to guide management.
KW - Childhood thyroid cancer
KW - Children
KW - Ongoing risk stratification
KW - Persistent disease
KW - Response to treatment
KW - Thyroid cancer
UR - http://www.scopus.com/inward/record.url?scp=85111367430&partnerID=8YFLogxK
U2 - 10.3390/cancers13153732
DO - 10.3390/cancers13153732
M3 - Article
AN - SCOPUS:85111367430
SN - 2072-6694
VL - 13
JO - Cancers
JF - Cancers
IS - 15
M1 - 3732
ER -