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Eur J Pediatr Surg 2016; 26(06): 524-532
DOI: 10.1055/s-0035-1569150
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Surgically Treated Pediatric Nonpapillary Thyroid Carcinoma

Samuel Golpanian
1   Department of Pediatric Surgery, University of Miami, Miami, Florida, United States
,
Jun Tashiro
1   Department of Pediatric Surgery, University of Miami, Miami, Florida, United States
,
Juan E. Sola
1   Department of Pediatric Surgery, University of Miami, Miami, Florida, United States
,
Casey Allen
1   Department of Pediatric Surgery, University of Miami, Miami, Florida, United States
,
John I. Lew
1   Department of Pediatric Surgery, University of Miami, Miami, Florida, United States
,
Anthony R. Hogan
1   Department of Pediatric Surgery, University of Miami, Miami, Florida, United States
,
Holly L. Neville
1   Department of Pediatric Surgery, University of Miami, Miami, Florida, United States
,
Eduardo A. Perez
1   Department of Pediatric Surgery, University of Miami, Miami, Florida, United States
› Institutsangaben
Weitere Informationen

Publikationsverlauf

12. Juli 2015

17. Oktober 2015

Publikationsdatum:
18. Dezember 2015 (online)

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Abstract

Introduction This study aims to update outcomes and predictors of survival on pediatric thyroid carcinoma, specifically examining pediatric patients with nonpapillary thyroid carcinoma who underwent surgical resection.

Methods Surveillance, epidemiology, and end results database were searched for pediatric cases (< 20 years old) of surgically treated nonpapillary thyroid carcinoma diagnosed from 1973 to 2011. Demographics, clinical characteristics, and survival outcomes were analyzed using standard statistical methods. All follicular, medullary, Hürthle-cell, and nonencapsulated sclerosing carcinoma types were included.

Results A total of 493 cases were identified. The overall incidence was 0.096/100,000 persons per year. The mean age at diagnosis was 15 years and highest incidence was found in whites, females, and patients aged 15 to 19 years. Most patients had localized (60%) or regional disease (35%) and only 38% received radiation (any type). Subtotal/total thyroidectomy was the most common procedure performed (83%) and 47% had lymph node sampling. The most common histologies were follicular (54%) and medullary (28%). Most tumors were > 2cm in size (63%). Overall 30-year survival was 91% but higher for females (94%, p = 0.02) and for local disease (92%). Disease-specific survival was highest for those with no lymph node sampling and negative lymph nodes. On multivariate analysis for medullary type only stage was an independent prognostic indicator of survival. Gender, age, tumor size, histology, and disease extent were not associated with an increased risk of mortality.

Conclusions Incidence of pediatric nonpapillary thyroid cancer is low. Females have a higher incidence but similar survival to males. Stage is the only independent prognostic indicator of survival for patients with medullary thyroid cancer.

Keywords

nonpapillary thyroid carcinoma - pediatric - survival - outcome predictors
 

  • References

  • 1 Dinauer CA, Breuer C, Rivkees SA. Differentiated thyroid cancer in children: diagnosis and management. Curr Opin Oncol 2008; 20 (1) 59-65
    CrossrefPubMedGoogle Scholar
  • 2 Halac I, Zimmerman D. Thyroid nodules and cancers in children. Endocrinol Metab Clin North Am 2005; 34 (3) 725-744 , x
    CrossrefPubMedGoogle Scholar
  • 3 Grigsby PW, Gal-or A, Michalski JM, Doherty GM. Childhood and adolescent thyroid carcinoma. Cancer 2002; 95 (4) 724-729
    CrossrefPubMedGoogle Scholar
  • 4 Hogan AR, Zhuge Y, Perez EA, Koniaris LG, Lew JI, Sola JE. Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients. J Surg Res 2009; 156 (1) 167-172
    CrossrefPubMedGoogle Scholar
  • 5 National Cancer Institute. Surveillance, Epidemiology, and End Results (SEER) surveillance research program, cancer statistics branch (2014). Available at: http://seer.cancer.gov/ . Accessed April 30, 2015
    PubMedGoogle Scholar
  • 6 Millman B, Pellitteri PK. Thyroid carcinoma in children and adolescents. Arch Otolaryngol Head Neck Surg 1995; 121 (11) 1261-1264
    CrossrefPubMedGoogle Scholar
  • 7 Corrias A, Mussa A, Baronio F , et al; Study Group for Thyroid Diseases of Italian Society for Pediatric Endocrinology and Diabetology (SIEDP/ISPED). Diagnostic features of thyroid nodules in pediatrics. Arch Pediatr Adolesc Med 2010; 164 (8) 714-719
    CrossrefPubMedGoogle Scholar
  • 8 Cady B. Presidential address: beyond risk groups—a new look at differentiated thyroid cancer. Surgery 1998; 124 (6) 947-957
    CrossrefPubMedGoogle Scholar
  • 9 Wiersinga WM. Management of thyroid nodules in children and adolescents. Hormones (Athens) 2007; 6 (3) 194-199
    PubMedGoogle Scholar
  • 10 Luster M, Lassmann M, Freudenberg LS, Reiners C. Thyroid cancer in childhood: management strategy, including dosimetry and long-term results. Hormones (Athens) 2007; 6 (4) 269-278
    CrossrefPubMedGoogle Scholar
  • 11 La Quaglia MP, Black T, Holcomb III GW , et al. Differentiated thyroid cancer: clinical characteristics, treatment, and outcome in patients under 21 years of age who present with distant metastases. A report from the Surgical Discipline Committee of the Children's Cancer Group. J Pediatr Surg 2000; 35 (6) 955-959 , discussion 960
    CrossrefPubMedGoogle Scholar
  • 12 Dzepina D. Surgical and pathological characteristics of papillary thyroid cancer in children and adolescents. Int J Pediatr 2012; 2012: 125389
    PubMedGoogle Scholar
  • 13 Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013; 63 (1) 11-30
    CrossrefPubMedGoogle Scholar
  • 14 Sipos JA, Mazzaferri EL. Thyroid cancer epidemiology and prognostic variables. Clin Oncol (R Coll Radiol) 2010; 22 (6) 395-404
    CrossrefPubMedGoogle Scholar
  • 15 Segal K, Hadar T, Lubin E, Abraham A, Levy R. [Thyroid carcinoma in children and adolescents]. Harefuah 1992; 122 (2) 83-86
    PubMedGoogle Scholar
  • 16 Bal CS, Padhy AK, Kumar A. Clinical features of differentiated thyroid carcinoma in children and adolescents from a sub-Himalayan iodine-deficient endemic zone. Nucl Med Commun 2001; 22 (8) 881-887
    CrossrefPubMedGoogle Scholar
  • 17 Harach HR, Williams ED. Childhood thyroid cancer in England and Wales. Br J Cancer 1995; 72 (3) 777-783
    CrossrefPubMedGoogle Scholar
  • 18 Collini P, Massimino M, Leite SF , et al; Thyroid Cancer Study Group of the Istituto Nazionale Tumori of Milan, Italy. Papillary thyroid carcinoma of childhood and adolescence: a 30-year experience at the Istituto Nazionale Tumori in Milan. Pediatr Blood Cancer 2006; 46 (3) 300-306
    CrossrefPubMedGoogle Scholar
  • 19 von der Weid NX. Adult life after surviving lymphoma in childhood. Support Care Cancer 2008; 16 (4) 339-345
    CrossrefPubMedGoogle Scholar
  • 20 Tuttle RM, Becker DV. The Chernobyl accident and its consequences: update at the millennium. Semin Nucl Med 2000; 30 (2) 133-140
    CrossrefPubMedGoogle Scholar
  • 21 Shapiro NL, Bhattacharyya N. Population-based outcomes for pediatric thyroid carcinoma. Laryngoscope 2005; 115 (2) 337-340
    CrossrefPubMedGoogle Scholar
  • 22 Vander Poorten V, Hens G, Delaere P. Thyroid cancer in children and adolescents. Curr Opin Otolaryngol Head Neck Surg 2013; 21 (2) 135-142
    CrossrefPubMedGoogle Scholar
  • 23 Hung W, Sarlis NJ. Current controversies in the management of pediatric patients with well-differentiated nonmedullary thyroid cancer: a review. Thyroid 2002; 12 (8) 683-702
    CrossrefPubMedGoogle Scholar
  • 24 Thompson GB, Hay ID. Current strategies for surgical management and adjuvant treatment of childhood papillary thyroid carcinoma. World J Surg 2004; 28 (12) 1187-1198
    CrossrefPubMedGoogle Scholar
  • 25 La Quaglia MP, Corbally MT, Heller G, Exelby PR, Brennan MF. Recurrence and morbidity in differentiated thyroid carcinoma in children. Surgery 1988; 104 (6) 1149-1156
    PubMedGoogle Scholar
  • 26 Harness JK, Thompson NW, McLeod MK, Pasieka JL, Fukuuchi A. Differentiated thyroid carcinoma in children and adolescents. World J Surg 1992; 16 (4) 547-553 , discussion 553–554
    CrossrefPubMedGoogle Scholar
  • 27 Farid NR, Zou M, Shi Y. Genetics of follicular thyroid cancer. Endocrinol Metab Clin North Am 1995; 24 (4) 865-883
    PubMedGoogle Scholar
  • 28 Harness JK. Childhood thyroid carcinoma. In: Clark OH, Duh Q-Y. eds. Textbook of Endocrine Surgery. Philadelphia, PA: Saunders; 1997: 75-81
    Google Scholar
  • 29 Rosai J, Luisa Carcangiu M, DeLelli RA. Atlas of Tumor Pathology: Tumors of the Thyroid Gland. 1992. Washington, DC: AFIP;
    Google Scholar
  • 30 Spinelli C, Bertocchini A, Antonelli A, Miccoli P. Surgical therapy of the thyroid papillary carcinoma in children: experience with 56 patients < or =16 years old. J Pediatr Surg 2004; 39 (10) 1500-1505
    CrossrefPubMedGoogle Scholar
  • 31 Viola D, Romei C, Elisei R. Medullary thyroid carcinoma in children. Endocr Dev 2014; 26: 202-213
    PubMedGoogle Scholar
  • 32 Diesen DL, Skinner MA. Pediatric thyroid cancer. Semin Pediatr Surg 2012; 21 (1) 44-50
    CrossrefPubMedGoogle Scholar
  • 33 Collini P, Mattavelli F, Pellegrinelli A, Barisella M, Ferrari A, Massimino M. Papillary carcinoma of the thyroid gland of childhood and adolescence: Morphologic subtypes, biologic behavior and prognosis: a clinicopathologic study of 42 sporadic cases treated at a single institution during a 30-year period. Am J Surg Pathol 2006; 30 (11) 1420-1426
    CrossrefPubMedGoogle Scholar
  • 34 Yen TW, Shapiro SE, Gagel RF, Sherman SI, Lee JE, Evans DB. Medullary thyroid carcinoma: results of a standardized surgical approach in a contemporary series of 80 consecutive patients. Surgery 2003; 134 (6) 890-899 , discussion 899–901
    CrossrefPubMedGoogle Scholar
  • 35 Raval MV, Sturgeon C, Bentrem DJ , et al. Influence of lymph node metastases on survival in pediatric medullary thyroid cancer. J Pediatr Surg 2010; 45 (10) 1947-1954
    CrossrefPubMedGoogle Scholar
  • 36 Frieda S, Francisco N-R, Reinaldo L. Thyroid cancer in the pediatric population. In: Fahey TJ, ed. Updates in the Understanding and Management of Thyroid Cancer (pp.189–198). 2012. Rijeka, Croatia: InTech;
    CrossrefGoogle Scholar
  • 37 Cobin RH, Gharib H, Bergman DA , et al; Thyroid Carcinoma Task Force; American Association of Clinical Endocrinologists. American College of Endocrinology. AACE/AAES medical/surgical guidelines for clinical practice: management of thyroid carcinoma. Endocr Pract 2001; 7 (3) 202-220
    CrossrefPubMedGoogle Scholar
  • 38 Jarzab B, Handkiewicz Junak D, Włoch J , et al. Multivariate analysis of prognostic factors for differentiated thyroid carcinoma in children. Eur J Nucl Med 2000; 27 (7) 833-841
    CrossrefPubMedGoogle Scholar
  • 39 Newman KD, Black T, Heller G , et al. Differentiated thyroid cancer: determinants of disease progression in patients <21 years of age at diagnosis: a report from the Surgical Discipline Committee of the Children's Cancer Group. Ann Surg 1998; 227 (4) 533-541
    CrossrefPubMedGoogle Scholar
  • 40 Rapkin L, Pashankar FD. Management of thyroid carcinoma in children and young adults. J Pediatr Hematol Oncol 2012; 34 (Suppl. 02) S39-S46
    CrossrefPubMedGoogle Scholar
  • 41 Rendl G, Manzl M, Hitzl W, Sungler P, Pirich C. Long-term prognosis of medullary thyroid carcinoma. Clin Endocrinol (Oxf) 2008; 69 (3) 497-505
    CrossrefPubMedGoogle Scholar
  • 42 Waguespack SG, Rich TA, Perrier ND, Jimenez C, Cote GJ. Management of medullary thyroid carcinoma and MEN2 syndromes in childhood. Nat Rev Endocrinol 2011; 7 (10) 596-607
    CrossrefPubMedGoogle Scholar
  • 43 Kloos RT, Eng C, Evans DB , et al; American Thyroid Association Guidelines Task Force. Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid 2009; 19 (6) 565-612
    CrossrefPubMedGoogle Scholar
  • 44 Brink JS, van Heerden JA, McIver B , et al. Papillary thyroid cancer with pulmonary metastases in children: long-term prognosis. Surgery 2000; 128 (6) 881-886 , discussion 886–887
    CrossrefPubMedGoogle Scholar
  • 45 Roman S, Lin R, Sosa JA. Prognosis of medullary thyroid carcinoma: demographic, clinical, and pathologic predictors of survival in 1252 cases. Cancer 2006; 107 (9) 2134-2142
    CrossrefPubMedGoogle Scholar
  • 46 Brierley JD, Tsang RW. External beam radiation therapy for thyroid cancer. Endocrinol Metab Clin North Am 2008; 37 (2) 497-509 , xi
    CrossrefPubMedGoogle Scholar
  • 47 Wray CJ, Rich TA, Waguespack SG, Lee JE, Perrier ND, Evans DB. Failure to recognize multiple endocrine neoplasia 2B: more common than we think?. Ann Surg Oncol 2008; 15 (1) 293-301
    CrossrefPubMedGoogle Scholar
  • 48 Bernstein L, Gurney JG. Carcinomas and other malignant epithelial neoplasms. Available at: http://seer.cancer.gov/archive/publications/childhood/childhood-monograph.pdf . Accessed June 12, 2015
    PubMedGoogle Scholar
  • 49 Saad MF, Ordonez NG, Rashid RK , et al. Medullary carcinoma of the thyroid. A study of the clinical features and prognostic factors in 161 patients. Medicine (Baltimore) 1984; 63 (6) 319-342
    CrossrefPubMedGoogle Scholar