Differentiated thyroid cancer in children: Heterogeneity of predictive risk factors(288 views) Russo M, Malandrino P, Moleti M, Vermiglio F, D'Angelo A, La Rosa G, Sapuppo G, Calaciura F, Regalbuto C, Belfiore A, Vigneri R, Pellegriti G
Pediatr Blood Cancer (ISSN: 1545-5009linking), 2018 Sep; 65(9): e27226-e27226.
Keywords: Ongoing Risk Stratification
, Thyroid Cancer
, Thyroid Cancer In Paediatric Age, Iodine 131, Adolescent, Adult, Article, Cancer Diagnosis, Cancer Patient, Cancer Prognosis, Cancer Radiotherapy, Cancer Recurrence, Cancer Risk, Cancer Surgery, Cancer Survival, Child, Childhood Cancer, Clinical Feature, Clinical Outcome, Differentiated Thyroid Cancer, Distant Metastasis, Female, Follow Up, Hashimoto Disease, Histopathology, Human, Infant, Long Term Survival, Lung Metastasis, Lymph Node Dissection, Lymph Node Metastasis, Major Clinical Study, Medical Record Review, Newborn, Predictive Value, Priority Journal, Radioisotope Therapy, Retrospective Study, Risk Factor, Thyroid Follicular Carcinoma, Thyroid Papillary Carcinoma, Thyroidectomy, Tumor Volume,
Affiliations: *** IBB - CNR ***
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Endocrinology Division, Department of Clinical and Experimental Medicine, Garibaldi-Nesima Medical Center, University of Catania, Catania, Italy.
Institute of Biostructure and Bioimaging, National Research Council, Catania, Italy.
References: To correlate clinical and pathological
characteristics at diagnosis with patient long-term outcomes and to
evaluate ongoing risk stratifications in a large series of paediatric
differentiated thyroid cancers (DTC).
STUDY DESIGN:
analysis of clinical and pathological prognostic factors of 124
paediatric patients with DTC (age at diagnosis <19 years) followed up
for 10.4 ± 8.4 years. Patients with a follow-up >3 years (n = 104)
were re-classified 18 months after surgery on the basis of their
response to therapy (ongoing risk stratification).
patients had a papillary histotype (96.0%), were older than 15 years
(75.0%) and were diagnosed because of clinical local symptoms (63.7%).
Persistent/recurrent disease was present in 31.5% of cases during
follow-up, but at the last evaluation, only 12.9% had biochemical or
structural disease. The presence of metastases in the lymph nodes of the
lateral compartment (OR 3.2, 95% CI, 1.28-7.16, P = 0.01) was the only
independent factor associated with recurrent/persistent disease during
follow-up. At the last evaluation, biochemical/structural disease was
associated with node metastases (N1a, N1b) by univariate but not
multivariate analysis. Ongoing risk stratification compared to the
initial risk classification method better identified patients with a
lower probability of persistent/recurrent disease (NPV = 100%).
CONCLUSIONS:
spite of the aggressive presentations at diagnosis, paediatric patients
with DTC show an excellent response to treatment and often a favourable
outcome. N1b status should be considered a strong predictor of
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Differentiated thyroid cancer in children: Heterogeneity of predictive risk factors
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