Differentiated thyroid carcinoma in childhood and adolescence—clinical course and role of radioiodine

Chow, Sin‐Ming; Law, Stephen C.K.; Mendenhall, William M.; Au, Siu-Kie; Yau, Stephen S.-T.; Mang, Oscar; Lau, W.S.

doi:10.1002/pbc.10410

Cited by 125 publications

(101 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As reported in our previous study, age O45 is an independent poor prognostic factor for LR FFS, DM FFS, and CSS (Chow et al 2002c). However, young patients of age !21 has higher rate of LR failures but better survival than age R21 (Chow et al 2004b). In this study, RAI improved LR control in patients with T1 or T2 disease with age %45, showing its efficiency in local control in low risk patients.…”

Section: Local Controlmentioning

confidence: 79%

Local and regional control in patients with papillary thyroid carcinoma: specific indications of external radiotherapy and radioactive iodine according to T and N categories in AJCC 6th edition

Chow

Yau²,

Kwan

et al. 2006

Endocr Relat Cancer

Self Cite

134

View full text Add to dashboard Cite

To identify indications for external radiotherapy (EXT) and radioactive iodine (RAI) in papillary thyroid carcinoma (PTC), we conducted a retrospective study of local and regional control in 1297 patients diagnosed with PTC in a tertiary referral center. Managed by surgery alone, patients with bilateral thyroidectomy had a lower rate of local relapse compared with lobectomy (PZ0.02). EXT improved locoregional (LR) failure-free survival (FFS) (P!0.001) and survival (PZ0.01) in patients with gross postoperative LR residual disease. EXT also improved local FFS in patients with pathologically confirmed positive resection margins (P!0.001) and reduced local failures in patients with T4 disease (PZ0.002). In patients with lymph nodes (LN) metastasis, more extensive surgery by functional or radical neck dissection resulted in less LN relapse compared with excision alone (P!0.001). EXT improved 10-year LN FFS in patients with N1b disease (PZ0.005) and patients with LN metastasis of size O2 cm (PZ0.02). RAI was effective in improving local control in patients with T2 to T4 diseases and LN control in patients with N0, N1a, and N1b categories. Local or LN relapses were associated with worse survival (P!0.001 and P!0.0001). The survival of patients with PTC could be improved by reducing local or LN relapses. RAI is indicated in patients with T2 to T4 disease. EXT is indicated in patients with gross postoperative disease, positive resection margins or T4 disease, N1b, or a LN size of O2 cm. LN relapse can be reduced by RAI in N0, N1a, and N1b disease.

show abstract

Section: Local Controlmentioning

confidence: 79%

Local and regional control in patients with papillary thyroid carcinoma: specific indications of external radiotherapy and radioactive iodine according to T and N categories in AJCC 6th edition

Chow

Yau²,

Kwan

et al. 2006

Endocr Relat Cancer

Self Cite

134

View full text Add to dashboard Cite

show abstract

“…Data available from the literature also demonstrate a higher frequency of lung metastases in children as compared with adult cases (32). In a recent series, Chow et al found pulmonary metastases in 15% of patients aged less than 21 years and 7.8% in the older individuals (33). In our experience, children with lung metastases usually have nodal disease with large thyroid nodules accessible by palpation without labored breathing in most instances.…”

Section: Clinical Course Of Childhood Patients With Thyroid Cancermentioning

confidence: 84%

Childhood thyroid cancer in Belarus, Russia, and Ukraine after Chernobyl and at present

Demidchik

Saenko

Yamashita

2007

Arq Bras Endocrinol Metab

121

View full text Add to dashboard Cite

Thyroid cancer in children is usually rare, but in the individuals exposed to radiation risk of disease increases considerably. After the Chernobyl accident in 1986, an over 10-fold maximal elevation in the incidence of thyroid cancer was registered about a decade later, cumulatively resulting in more than a thousand of newly diagnosed cases in children who lived in the territories of Belarus, Russia, and Ukraine affected by radioactive fallouts. Experience from the epidemic substantially promoted knowledge in clinical pediatric oncology, pathology and basic sciences. This article overviews epidemiology, clinical features, results of treatment and followup of childhood patients with radiation-induced Chernobyl thyroid cancer in comparison to sporadic cases diagnosed at present. In addition, we discuss general issues of pathology and molecular findings in childhood thyroid carcinomas. RESUMOCâncer de Tiróide na Infância na Bielorússia, Rússia, e na Ucrânia, Após Chernobil e Atualmente. O câncer de tiróide é habitualmente raro em crianças, mas em indivíduos expostos a radiação o risco da doença aumenta consideravelmente. Cerca de uma década após o acidente de Chernobil, em 1986, foi registrado um aumento de mais de 10 vezes na incidência de câncer de tiróide, resultando cumulativamente em mais de mil novos casos diagnosticados em crianças que viviam nos territórios da Bielorrússia, Russia, e Ucrânia, afetadas pela chuva radioativa. A experiência com essa epidemia resultou em conhecimento substancial de oncologia pediátrica clínica, patologia e ciências básicas. Este artigo analisa a epidemiologia, os achados clínicos, os resultados do tratamento e a evolução de pacientes pediátricos com câncer de tiróide induzido pela radiação de Chernobil, em comparação com casos esporádicos diagnosticados atualmente. Adicionalmente, serão discutidos tópicos de patologia e achados moleculares no carcinoma de tiróide infantil.

show abstract

“…Treatment with TTx, lymph node dissection, and RAI is considered appropriate for preventing recurrence (18,20,21,36). Chow et al (38) reported that RAI reduced the risk of both locoregional and distant recurrences. They did not detect secondary malignancy or impairment of fertility and pregnancy outcomes.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Disease in Juvenile Differentiated Thyroid Carcinoma: Prognostic Factors, Treatments, and Outcomes

2014

View full text Add to dashboard Cite

The overall prognosis in pediatric differentiated thyroid carcinoma (DTC) is excellent. Recurrent disease is frequent, however, and requires additional treatment. We analyzed the probability of recurrence, prognostic factors, treatment, and outcome of juvenile DTC. Methods: Fifty-one DTC patients (32 girls and 19 boys; ≤20 y old; mean age, 16.5 y) were treated with 131 I (radioiodine, or radioactive iodine [RAI]); the median follow-up was 10 y. Patients underwent different initial treatments: 46 patients received total thyroidectomy and RAI, 3 patients received total thyroidectomy, and 3 patients received subtotal thyroidectomy. The probability of recurrence and prognostic factors were tested with the Kaplan-Meier method. Results: Initially, 36 of 51 patients achieved complete remission, 14 of 51 achieved partial remission, and 1 of 51 had progressive disease. By the follow-up, 11 of 51 patients (21.6%) had developed recurrent disease; the median appearance time was 4 y (range, 1-15 y). The probabilities of recurrence were 16.7% at 5 y, 22.3% at 10 y, and 33.3% at 15 and 23 y after the initial treatments. Factors that were strongly predictive of recurrence were age (P 5 0.001), initial treatment (P 5 0.0001), and tumor multifocality (P 5 0.011). Sex, nodal metastases at presentation, distal metastases at presentation, histologic type of the tumor, T stage, and clinical stage had no influence on relapse (P 5 0.180, P 5 0.786, P 5 0.796, P 5 0.944, P 5 0.352, and P 5 0.729, respectively). Patients with recurrent disease, partial remission, and progressive disease were retreated, with either surgery or surgery and RAI, receiving cumulative activities of up to 40 GBq. The overall outcome in our patients was excellent: 90.2% complete remission, 3.92% partial remission, 1.96% stable disease, 1.96% disease-related death, and 1.96% another cause of death. Conclusion: Younger age at diagnosis, less radical primary surgery without subsequent RAI, and tumor multifocality are factors that are strongly prognostic for recurrence. For reducing the rate of relapse and improving surveillance for recurrent disease, total thyroidectomy followed by RAI appears to be the most beneficial initial treatment for patients with juvenile DTC. The use of RAI seems to be safe, with no adverse effects on subsequent fertility and pregnancy or secondary malignancy.

show abstract

Differentiated thyroid carcinoma in childhood and adolescence—clinical course and role of radioiodine

Cited by 125 publications

References 50 publications

Local and regional control in patients with papillary thyroid carcinoma: specific indications of external radiotherapy and radioactive iodine according to T and N categories in AJCC 6th edition

Local and regional control in patients with papillary thyroid carcinoma: specific indications of external radiotherapy and radioactive iodine according to T and N categories in AJCC 6th edition

Childhood thyroid cancer in Belarus, Russia, and Ukraine after Chernobyl and at present

Recurrent Disease in Juvenile Differentiated Thyroid Carcinoma: Prognostic Factors, Treatments, and Outcomes

Contact Info

Product

Resources

About