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Total Thyroidectomy and Adjuvant Radioiodine Treatment Independently Decrease Locoregional Recurrence Risk in Childhood and Adolescent Differentiated Thyroid Cancer

¹ Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland; ² Department of Surgical Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland; ³ Department of Endocrinological and General Surgery, Medical University of Lodz, Lodz, Poland; and ⁴ Department of Pediatric Surgery, Rydygier Medical University, Bydgoszcz, Poland

View larger version (10K): [in this window] [in a new window]   FIGURE 1.  Institutional receiver-operating-characteristic curves for serum Tg measurements (based on 1,847 Tg measurements on 1,122 patients of all ages with DTC) (20).

View larger version (10K): [in this window] [in a new window]   FIGURE 2.  TBRFS by thyroid surgery category. Intergroup difference, P < 0.00005; Cox–Mantel test. Survival curves are cut at 200 mo, when only 11 patients were still under observation for this outcome (patients in follow-up: 149 at 5 y, 53 at 10 y, 5 at 20 y).

View larger version (10K): [in this window] [in a new window]   FIGURE 3.  TBRFS by radioiodine treatment category. Intergroup difference, P < 0.0005; Cox–Mantel test. Survival curves are cut at 200 mo, when only 11 patients were still under observation for this outcome (patients in follow-up: 149 at 5 y, 53 at 10 y, 5 at 20 y).

View larger version (12K): [in this window] [in a new window]   FIGURE 4.  NRFS by lymph node metastasis status at end of primary treatment. Intergroup differences: (1) vs. (2), P = 0.04; (1) vs. (3), P = 0.006; (2) vs. (3), P = 0.3; Cox–Mantel test. Survival curves are cut at 200 mo, when 15 patients were still under observation for this outcome (patients in follow-up: 141 at 5 y, 55 at 10 y, 8 at 20 y).

View larger version (10K): [in this window] [in a new window]   FIGURE 5.  NRFS by lymph node surgical management category. Intergroup differences: (1) vs. (2), P = 0.3; (1) vs. (3), P = 0.014; (2) vs. (4), P = 0.0006; (3) vs. (4), P = 0.2; (1) + (2) vs. (3) + (4), P = 0.02; Cox–Mantel test. Survival curves are cut at 200 mo, when 15 patients were still under observation for this outcome (patients in follow-up: 141 at 5 y, 55 at 10 y, 8 at 20 y).

View larger version (9K): [in this window] [in a new window]   FIGURE 6.  NRFS by radioiodine treatment category. Intergroup difference, P < 0.0005; Cox–Mantel test. Survival curves are cut at 200 mo, when 15 patients were still in observation for this outcome (patients in follow-up: 141 at 5 y, 55 at 10 y, 8 at 20 y).

View larger version (11K): [in this window] [in a new window]   FIGURE 7.  NRFS by thyroid surgery category. Intergroup difference, P < 0.05; Cox–Mantel test. Survival curves are cut at 200 mo, when 15 patients were still in observation for this outcome (patients in follow-up: 141 at 5 y, 55 at 10 y, 8 at 20 y).