Pediatric Differentiated Thyroid Carcinoma Risk Factor For Analysis For Disease Free Survival

Abstract

Context: The context of this study was epidemiology pediatric thyroid cancer in Bandung, Indonesia. Aims: The aim of this study is to evaluate clinical characteristics and outcome between children and young adult patients with differentiated thyroid cancer (DTC) treated in our hospital. Settings and Design: This was a cohort retrospective study. Materials and Methods: The medical records of 144 patients with DTC who underwent thyroid surgery followed by radioiodine and thyroid hormone suppression were retrospectively reviewed. Thyroid cancers were diagnosed between January 2007 and December 2010. Participants consisted of 43 patients who were younger than 21 years old and 101 young adult patients (older than 21 years old but younger or equal to 40 years). The clinical characteristics and outcomes were analyzed and compared, and then, recurrence-free survival was evaluated using Kaplan–Meier methods. Statistical Analysis Used: Software R 3.3.0 version for Windows was used in this study. Results: Female has higher tendency to have thyroid cancer than male (P = 0.006). Based on histopathology report, classic papillary thyroid cancer is the most common cancer type in children than young adult. However, there was no significant difference between two groups regarding thyroid cancer size and multifocality (P = 0.815 and P = 0.370). The risk of recurrent ratio of children to young adults is 3.88 (95% confidence interval [CI] 1.38; 10.91). A similar result trend has been shown for sex type, histopathology type, number of nodules, surgical technique, and metastasis parameters (adjusted hazard ratio = 7.91, 95% CI 2.11; 29.67). Conclusions: DTC in children shows more aggressive behavior compared to young adult patients.

Differentiated thyroid carcinoma in children: A retrospective analysis of 125 pediatric cases from a single institution in India

“…All of them had a tumor size found an increased rate of recurrence in patients with lymph node metastasis. 22,23 Similar to these studies, lymph node metastasis was found to be significantly correlating with recurrence in univariate analysis and remained marginally significant in multivariate analysis as well.…”

“…RAI ( 131 I), due to its ability to ablate normal remnant thyroid tissue and to treat iodine‐avid metastatic disease, has been used as an adjunct to surgical therapy. Radioablation is a frequently used modality of treatment used in 59–92% of reported cohorts and 62% of our patients received this modality 10,22,23 . As there are no uniform guidelines regarding the dose of RAI in children, different institutes used different doses of RAI based on weight/age of the child, or radioiodine uptake in the thyroid bed.…”

“…Radioablation is a frequently used modality of treatment used in 59-92% of reported cohorts and 62% of our patients received this modality. 10,22,23 As there are no uniform guidelines regarding the dose of RAI in children, different institutes used different doses of RAI based on weight/age of the child, or radioiodine uptake in the thyroid bed. 4,24 Our institutional policy was to give RAI at a dose of 1-1.5 mCi/kg for children aged <10 years.…”

Clinicopathological Profile of Thyroid Carcinoma in Young Patients: An Indonesian Single-Center Study

“…Age, radiation exposure of the head and neck region, family history, and environmental exposure are risk factors for thyroid malignancy [5,6]. e mortality rate of thyroid malignancy in children is usually <10%, but the recurrence rate is higher in children who are diagnosed when younger than 15 years with clinical presentation usually more severe than in adults [2,7]. yroid malignancy in younger patients has different characteristics than in adults in terms of clinical presentation, pathogenesis, and outcome owing to its biologic and molecular differences [7].…”

“…e mortality rate of thyroid malignancy in children is usually <10%, but the recurrence rate is higher in children who are diagnosed when younger than 15 years with clinical presentation usually more severe than in adults [2,7]. yroid malignancy in younger patients has different characteristics than in adults in terms of clinical presentation, pathogenesis, and outcome owing to its biologic and molecular differences [7]. Young patients with thyroid malignancy commonly do not show signs and symptoms but are diagnosed with malignant disease rather suddenly; therefore, it is often known as the silent killer [6].…”