Abstract
Background
Papillary and follicular thyroid cancer is a common malignancy in young patients, and the incidence of this cancer has been increasing. The aims of this study are to assess the clinical characteristics of papillary and follicular thyroid cancer in young patients and evaluate the long-term therapeutic outcomes and prognostic factors for cancer mortality and recurrence.
Methods
We performed a retrospective analysis of 116 patients aged ≤20 years who underwent thyroidectomy and a mean follow-up of 11.1 ± 0.6 years.
Results
There were 28 (24.1%) patients classified into the residual cancer or relapse groups. The progression-free survival rate for the young patients was lower than that of the patients between 20 and 45 years of age; however, the difference between the thyroid cancer survival rates was not statistically different. Two of the 28 patients died of thyroid cancer. Thirteen patients who showed relapsed underwent 131I whole-body scan; 6 of the 13 patients were diagnosed with distant metastases to the lung and 1 was diagnosed with distant metastases to the bones. Among the young patients, the 5- and 10-year progression-free survival rates were 79.1 and 73.4%, respectively, and the corresponding cancer survival rates were 99.1, and 96.5%, respectively.
Conclusion
The progression-free survival in young patients with papillary and follicular thyroid cancer was lower than the patients of age 20–45 years; otherwise, cancer survival was higher than age group over or equal to 45 years.
Similar content being viewed by others
References
Alston RD, Geraci M, Eden TO et al (2008) Changes in cancer incidence in teenagers and young adults (ages 13 to 24 years) in England 1979–2003. Cancer 113:2715–2807
Hogan AR, Zhuge Y, Perez EA et al (2009) Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients. J Surg Res 156:167–172
Ying AK, Huh W, Bottomley S et al (2009) Thyroid cancer in young adults. Semin Oncol 36:258–274
Wada N, Sugino K, Mimura T et al (2009) Treatment strategy of papillary thyroid carcinoma in children and adolescents: clinical significance of the initial nodal manifestation. Ann Surg Oncol 16:3442–3449
Parisi MT, Mankoff D (2007) Differentiated pediatric thyroid cancer: correlates with adult disease, controversies in treatment. Semin Nucl Med 37:340–356
Martin S, Ulrich C, Munsell M et al (2007) Delays in cancer diagnosis in underinsured young adults and older adolescents. Oncologists 12:816–824
Hebestreit H, Biko J, Drozd V et al (2011) Pulmonary fibrosis in youth treated with radioiodine for juvenile thyroid cancer and lung metastases after Chernobyl. Eur J Nucl Med Mol Imaging 38:1683–1690
Raval MV, Bentrem DJ, Stewart AK et al (2010) Utilization of total thyroidectomy for differentiated thyroid cancer in children. Ann Surg Oncol 17:2545–2553
Takano T, Yane K, Oue T et al (2009) Outpatient administration of radioactive iodine after total thyroidectomy for pediatric thyroid cancer: a report of three cases. Int J Pediatr Otorhinolaryngol 73:1810–1813
Verburg FA, Biko J, Diessl S et al (2011) I-131 Activities as High as Safely Administrable (AHASA) for the treatment of children and adolescents with advanced differentiated thyroid cancer. J Clin Endocrinol Metab 96(8):E1268–E1271
Sobin LH, UICC, Wittekind Ch (eds) (2002) TNM classification of malignant tumors, 6th edn. Wiley-Liss, New York, pp 52–56
Delellis RA, Lloyd RV, Heitx PU et al (2004) Pathology and genetics of tumors of endocrine organs. In: World Health Organization classification of tumours. IARC, Lyon, pp 73–76
Huang BY, Lin JD, Chao TC et al (2011) Therapeutic outcomes of papillary thyroid cancer patients in different risk groups. Oncology 80:123–129
Zhang DD, Zhou XH, Freeman DH et al (2002) A non-parametric method for the comparison of partial areas under ROC curves and its application to large health care data sets. Stat Med 21:701–715
Bargren AE, Meyer-Rochow GY, Delbridge LW et al (2009) Outcomes of surgically managed pediatric thyroid cancer. J Surg Res 156:70–73
Seybt MW, Terris DJ (2011) Minimally invasive thyroid surgery in children. Ann Otol Rhinol Laryngol 120:215–219
Steliarova-Foucher E, Stiller CA, Pukkala E et al (2006) Thyroid cancer incidence and survival among European children and adolescents (1978–1997): report from the Automated Childhood Cancer Information System project. Eur J Cancer 42:2150–2169
Hay ID, Gonzalez-Losada T, Reinalda MS et al (2010) Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008. World J Surg 34:1192–1202
Lin JD, Chao TC, Hsueh C et al (2009) High recurrent rate of multi-centric papillary thyroid carcinoma. Ann Surg Oncol 16:2609–2616
Rodolico V, Cabibi D, Pizzolanti G et al (2007) BRAF (V600E) mutation and p27 (kip1) expression in papillary carcinomas of the thyroid ≤1 cm and their paired lymph node metastases. Cancer 110:1218–1226
Lupi C, Giannini R, Ugolini C et al (2007) Association of BRAF V600E mutation with poor clinicopathological outcomes in 500 consecutive cases of papillary thyroid carcinoma. J Clin Endocrinol Metab 92:4085–4090
Martinez-Tello FJ, Martinez-Cabruja R, Fernandez-Martin J et al (1993) Occult carcinoma of the thyroid. A systematic autopsy study from Spain of two series performed with two different methods. Cancer 71:4022–4029
Furmanchuk AW, Roussak N, Ruchti C (1993) Occult thyroid carcinomas in the region of Minsk, Belarus. An autopsy study of 215 patients. Histopathology 23:319–325
Demidchik YE, Demidchik EP, Reiners C et al (2006) Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus. Ann Surg 243:525–532
Lin JD, Lin KJ, Chao TC et al (2012) Clinical presentations of thyroid cancer patients with multiple primary cancers. J Endocrinol Invest 2011 May 24 (Epub ahead of print)
Fallahi B, Adabi K, Majidi M et al (2011) Incidence of second primary malignancies during a long-term surveillance of patients with differentiated thyroid carcinoma in relation to radioiodine treatment. Clin Nucl Med 36:277–282
Wada N, Sugino K, Mimura T et al (2009) Pediatric differentiated thyroid carcinoma in stage I: risk factor analysis for disease free survival. BMC Cancer 9:306
Popovtzer A, Shpitzer T, Bahar G et al (2006) Thyroid cancer in children: management and outcome experience of a referral center. Otolaryngol Head Neck Surg 135:581–584
Kuo SF, Chao TC, Chang HY et al (2009) The role of radioactive iodine therapy in young patients with papillary thyroid cancer. Clin Nucl Med 34:4–6
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Huang, CH., Chao, TC., Hseuh, C. et al. Therapeutic outcome and prognosis in young patients with papillary and follicular thyroid cancer. Pediatr Surg Int 28, 489–494 (2012). https://doi.org/10.1007/s00383-012-3054-1
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00383-012-3054-1