Malignant endocrine tumours in childhood and adolescence - results of a retrospective analysis

Parlowsky, Thomas; Bucsky, Peter; Hof, M.A. van't; Kaatsch, Peter

doi:10.1055/s-2008-1046475

Cited by 15 publications

(16 citation statements)

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“…In childhood, its appearance is quite rare and has been described only in few cases in the world. Unfortunately, in the childhood, it has the same fatal outcome, as well as in adult patients [10–12]. Age of patients with anaplastic thyroid cancer at the time of diagnosis, according to our results, is an independent factor that was significantly associated with longer survival ( P < 0.05, RR = 0.65, 95% CI = 0.49 to 0.95).…”

Section: Discussionsupporting

confidence: 51%

Age as a Prognostic Factor in Anaplastic Thyroid Cancer

Živaljević

Tausanovic

Paunović

et al. 2014

International Journal of Endocrinology

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Background. Anaplastic thyroid cancer (ATC) is one of the tumors with the shortest survival in human medicine. Aim. The aim was to determine the importance of age in survival of patients with ATC. Material and Methods. We analyzed the data on 150 patients diagnosed with ATC in the period from 1995 to 2006. The Kaplan-Meier method and log-rank test were used to determine overall survival. Prognostic factors were identified by univariate and multivariate Cox regression analysis. Results. The youngest patient was 35 years old and the oldest was 89 years old. According to univariate regression analysis, age was significantly associated with longer survival in patients with ATC. In multivariate regression analysis, patients age, presence of longstanding goiter, whether surgical treatment is carried out or not, type of surgery, tumor multicentricity, presence of distant metastases, histologically proven preexistent papillary carcinoma, radioiodine therapy, and postoperative radiotherapy were included. According to multivariate analysis, besides surgery (P = 0.000, OR = 0.43, 95% CI = 0.29–0.63), only patients age (P = 0.023, OR = 0.68, 95% CI = 0.49–0.95) was independent prognostic factor of favorable survival in patients with ATC. Conclusion. Age is a factor that was independently associated with survival time in ATC. Anaplastic thyroid cancer has the best prognosis in patients younger than 50 years.

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Section: Discussionsupporting

confidence: 51%

Age as a Prognostic Factor in Anaplastic Thyroid Cancer

Živaljević

Tausanovic

Paunović

et al. 2014

International Journal of Endocrinology

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“…The both are designated as differentiated thyroid cancer (DTC) and represent about 90% of all malignant childhood thyroid tumors. The medullary type thyroid cancer (MTC) appears in about 10% of the patients, whereas the anaplastic subtype represents a rarity in the paediatric age group (Parlowsky et al, 1996).…”

Section: Epidemiologymentioning

confidence: 99%

“…To evaluate the therapeutic efficacy of a combined modality therapy by both radiotherapy and cytostatic drugs in children and adolescents with poor prognosis types of thyroid cancer; an interdisciplinary multicenter therapy study will now be started in Germany. sis, dealing also with other malignant endocrine tumors of childhood and adolescence (Parlowsky et al, 1996, Bucsky et al, 1995.…”

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confidence: 99%

Epidemiology and therapy of thyroid cancer in childhood and adolescence

Bucsky

Parlowsky²

2009

Exp Clin Endocrinol Diabetes

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Thyroid cancer is a rare disease in childhood and adolescence. However, it represents the most frequent cancer type in this age group. Thyroid cancer amounts about 0.5%-1.5% of all malignancies in children and adolescents. In Germany 10-30 cases could be expected in a year. The most common histologic type for this age group is the differentiated thyroid cancer (DTC), i.e. the papillary and follicular subtypes (90%). In 10% of patients medullary thyroid cancer (MTC) will be diagnosed. DTC occur more often in girls than in boys (female/male-ratio 2:1), with a median age of about 12-13 years (yrs). An important aetiological factor of DTC is a former exposition to different kinds of radiation. In childhood and adolescence MTC mostly appears in patients suffering from the syndrome MEN-2, whereas the sporadic form is rare. As in DTC, more girls than boys can be diagnosed for MTC (female/male-ratio 2-3:1), with a median age about 10 yrs. The anaplastic/undifferentiated subtype occurs extremely rare. For all types of thyroid cancer the most important therapeutic approach is the surgical intervention. In most cases of DTC an optimal disease control could be achieved by radioiodine therapy. Prognosis of DTC in children and adolescents is favourable. However, therapeutic strategies and modalities reported in the literature are very different. In contrast, prognosis of MTC is rather poor, that of the anaplastic type is infaust. No other effective therapy option than surgery is available. To evaluate the therapeutic efficacy of a combined modality therapy by both radiotherapy and cytostatic drugs in children and adolescents with poor prognosis types of thyroid cancer, an interdisciplinary multicenter therapy study will now be started in Germany.

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“…In Germany, children and adolescents with ACC are registered and treated according to the GPOH-MET 97 protocol [21]. The treatment of children with malignancies in Germany in a national trial or registry is, whenever possible, highly recommended [9,16].…”

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confidence: 99%

Surgical Aspects in the Treatment of Adrenocortical Carcinomas in Children: Data of the GPOH-MET 97 Trial

et al. 2012

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Adrenocortical carcinomas (ACCs) are a rare entity, with an incidence of 1.5 per million population per year. The prognosis of ACC is poor. Complete surgical resection is essential for a curative approach and significantly determines overall prognosis. Tumor resection is sophisticated and complicated by the vulnerability of the tumor and its invasive growth. Chemotherapy and Mitotane are additional therapeutic approaches that are combined with surgery in an interdisciplinary strategy. In this study, 59 patients between 2 months and 18 years of age with histologically verified ACC were analyzed retrospectively with respect to oncosurgical aspects. Patients were registered in the GPOH-MET 97 trial of the Society of Pediatric Oncology and Haematology. Preoperative management, factors influencing surgical severity, and operative complications were assessed.The gender ratio was 1:2 (m:f). A total of 58 patients showed increased hormonal activity and associated clinical signs of hormonal excess. Tumor volume was ≥ 300 mL in 25 patients. These patients showed an increased rate of operative complications and a poorer overall survival (OS) rate (p<0.01). A total of 14 patients showed metastatic spread, particularly to the lungs and lymph nodes. Biopsy of the tumor was performed in 12 patients. Tumor rupture occurred in 11 patients. Preoperative biopsy and/or experienced tumor rupture were associated with poorer OS rate. R2 resection only was achievable in 5 patients, and surgery was not feasible in 3 patients.In conclusion, since most of the pediatric ACC are hormone active and can be diagnosed clinically, the need of a tumor biopsy has to be discussed critically. Thorough pre- and perioperative management is essential for oncosurgical success.

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Malignant endocrine tumours in childhood and adolescence - results of a retrospective analysis

Cited by 15 publications

References 3 publications

Age as a Prognostic Factor in Anaplastic Thyroid Cancer

Age as a Prognostic Factor in Anaplastic Thyroid Cancer

Epidemiology and therapy of thyroid cancer in childhood and adolescence

Surgical Aspects in the Treatment of Adrenocortical Carcinomas in Children: Data of the GPOH-MET 97 Trial

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