Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors

Martucci, Cristina; Crocoli, Alessandro; Pasquale, Maria Debora De; Spinelli, Claudio; Strambi, Silvia; Brazzarola, Paolo; Morelli, Eleonora; Cassiani, Jessica; Mancera, Juliana; Luengas, Juan Pablo; Lobos, Pablo; Liberto, Daniel; Astori, Estefanìa; Sarnacki, Sabine; Couloigner, V.; Simon, François; Lambert, Cassandre; Abib, Simone de Campos Vieira; Cervantes, Onivaldo; Caran, Eliana Maria Monteiro; Lindman, Diana Delgado; Jones, Matthew O.; Shukla, R. K.; Losty, Paul D.; Inserra, Alessandro

doi:10.3389/fped.2022.914942

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…27 A recent paper described a trend towards a higher incidence of surgical morbidity in patients with STC. 28 The series was small, but our experience also suggests that patients treated with radiotherapy in the 1970s have hard necks with fibrotic tissues, and are therefore much more difficult to manage surgically.…”

Section: Secondary Osteosarcomamentioning

confidence: 89%

Treating secondary malignant neoplasms: A burden of childhood cancer survivors

Podda

Meazza

Gattuso

et al. 2023

Tumori

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Each year approximately 35,000 children and adolescents are diagnosed with cancer in Europe. Five-year survival rates have improved and now reach 80% in most European countries, thanks to a combination of chemotherapy, radiotherapy, and surgery. To date, there are more than 44,000 Italians still living several years after being diagnosed with cancer in developmental age. The risk of premature morbidity and mortality for cancer survivors is well known and documented. Approximately 60% of survivors of cancer in childhood and adolescence have at least one chronic health condition in later life, and more than one in four develop severe or life-threatening disorders. Among the various long-term iatrogenic sequelae of cancer treatments, the most worrisome are second malignant neoplasms. We reported on our mono-institutional experiences of screening and treating secondary breast cancer, secondary thyroid cancer and secondary osteosarcoma. Recommendations on the surveillance needed for cancer survivors because of the risk of late effects of their disease or its treatment suggest that discussing the potential problems early on can be crucial to a patient’s future health. These considerations and our consolidated experience strengthen our conviction that survivors of cancer in childhood and adolescence who develop second malignant neoplasms should be treated at highly-specialized centers. Multidisciplinary care requires close communications and high levels of up-to-date professional expertise. This challenging area of health care is also changing rapidly because cancer survivorship is a work in progress, but we cannot wait for definitive conclusions on many aspects because this will take decades, especially for pediatric patients.

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Section: Secondary Osteosarcomamentioning

confidence: 89%

Treating secondary malignant neoplasms: A burden of childhood cancer survivors

Podda

Meazza

Gattuso

et al. 2023

Tumori

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“…We showed a correlation between lymphadenectomy and more extensive surgery with longer hospitalization time. Martucci et al presented that according to international guidelines, prophylactic central and lateral neck excision is not recommended (34). They stated that it should only be performed in patients with malignant cytology (grade 4, 5, or 6 on the Bethesda scale) or when there is clear clinical evidence of extrathyroidal node involvement or locoregional metastasis based on preoperative staging or intraoperative findings.…”

Section: Discussionmentioning

confidence: 99%

Thyroid diseases in children and adolescents requiring surgical treatment—indications, techniques, results, and complications based on 10 years of the single center’s own experience

Sosnowska-Sienkiewicz,

Danielewicz,

Januszkiewicz-Lewandowska

et al. 2024

Front. Endocrinol.

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IntroductionAlthough thyroid abnormalities are observed less frequently in children than in adults, the increased incidence of thyroid cancer makes it mandatory for all pediatric surgeons to be knowledgeable about the disorders of this gland. Thyroid abnormalities can be associated with hyperthyroidism or hypothyroidism and euthyroidism and/or symmetric or asymmetric enlargement of the gland.AimThe present study was undertaken to retrospectively analyze the indications, surgical techniques used, results obtained, and complications found in the surgical treatment of thyroid diseases in children and adolescents in a surgical center for the macro-region of western Poland.MethodsThe data of 148 patients undergoing total or partial thyroidectomy between 2013 and 2022 were analyzed from the medical records of the Department of Pediatric Surgery, Traumatology, and Urology of the Medical University of Poznan, Poland.ResultsA total of 95 children underwent subtotal thyroidectomy and 64 underwent total thyroidectomy, of which the procedure was widened to include prophylactic removal of neck lymph nodes in 45 patients. There were 113 girls (76%) in the analyzed group, and the average age of the patients at the time of surgical treatment was 15 years. The average time from the diagnosis of thyroid disease to surgery was 4 months, ranging from 2 weeks to 3 years. Of the 64 patients undergoing total thyroid resection, 35 (54.69%) were diagnosed with thyroid cancer.ConclusionsCollaboration within a multidisciplinary team ensures optimal surgical outcomes in children and adolescents with thyroid disease. With extreme caution, thyroid removal is a safe procedure with few complications, but the experience of the surgeon performing thyroid surgery in children remains crucial. Despite the absence of such a diagnosis in the first fine-needle aspiration biopsy, the high percentage of thyroid carcinomas in the analyzed group may be because the initial biopsy was performed in a less experienced center, also in terms of histopathological laboratory. Hence, we point out the necessity of performing a repeat fine-needle aspiration biopsy (according to the Bethesda classification) in a more experienced center before the final decision of thyroidectomy.

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“…Pediatric DTCs behave differently from adult DTCs, with more aggressive initial presentation, but favorable long-term outcomes. 4,16 The spectrum of genomic abnormalities underlying childhood DTCs has also been seen to be markedly different from adult DTCs with a predominance of fusion oncogenes, particularly RET rearrangements. 6 This coupled with decreased frequency of BRAF and TERT promoter mutations seems to underlie the unique behavior of pediatric DTCs.…”

Section: Discussionmentioning

confidence: 99%

Appropriateness of 14‐year cutoff in pediatric differentiated thyroid cancer: Comparison of clinical characteristics and long‐term outcomes in 14 years and younger and 15–18 years age groups

Satapathy

Majeed

Ballal

et al. 2023

Pediatric Blood & Cancer

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BackgroundPediatric differentiated thyroid cancers (DTCs) differ in pathophysiology, presentation, and clinical outcomes from adult DTCs. However, the cutoff age for defining pediatric DTCs remains debatable, with the American Thyroid Association (ATA) and International Incidence of Childhood Cancer (IICC) report recommending different cutoffs of 18 and 14 years, respectively. In this study, we investigated the appropriateness of 14‐year cutoff by comparing the clinical characteristics and long‐term outcomes in the 14 years and younger and 15–18 years age groups.MethodsData of DTC patients, aged 18 years and older, from 1981 to 2016, were sequentially extracted and compared between two age groups: ≤14 and 15–18 years.ResultsTotal of 176 pediatric DTC patients were included (age group ≤14 years: n = 75; age group 15–18 years: n = 101). None of the baseline clinical characteristics were significantly different between the two age groups. At 2‐year follow‐up, patients in the age group ≤14 years had significantly higher incomplete response rate compared to those in the age group 15–18 years (69% vs. 42%, respectively, p < .001). However, over a median follow‐up of 10.6 years (interquartile range: 7.7–15.5), the 5‐ and 10‐year Disease‐free survival (DFS) probabilities were not significantly different (p = .406). On multivariate analysis, incomplete response at 2‐year follow‐up was the sole independent predictor of poor DFS (hazard ratio: 5.85, 95% confidence interval: 1.69–20.23).ConclusionsSubdivision of pediatric DTCs into less than or equal to 14 years and 15–18 years age groups did not have any long‐term predictive value. The cutoff of 18 years as recommended by ATA is reasonable and should be uniformly followed to avoid inconsistencies and confusion.

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Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors

Cited by 10 publications

References 30 publications

Treating secondary malignant neoplasms: A burden of childhood cancer survivors

Treating secondary malignant neoplasms: A burden of childhood cancer survivors

Thyroid diseases in children and adolescents requiring surgical treatment—indications, techniques, results, and complications based on 10 years of the single center’s own experience

Appropriateness of 14‐year cutoff in pediatric differentiated thyroid cancer: Comparison of clinical characteristics and long‐term outcomes in 14 years and younger and 15–18 years age groups

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