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☆,☆☆
Section snippets
Materials and methods
This analysis includes patients from all the institutions listed in the Appendix. Details regarding the definition of staging, treatment, and outcome variables have been published previously.1 Patient lists were obtained by individual institutional review of hospital archives, registries, and databases in an attempt to capture all consecutively treated differentiated thyroid cancer patients at each institution. Patients included in this study had their disease diagnosed on or between January 1,
Patient characteristics
There were 57 (69%) girls and 26 (31%) boys, and 92% of the patients were white. The median age was 14.6 years (range, 6.6 to 20.8 years; mean, 14.7 ± 3.7 years). The family history was positive in 9.9%, and 12.2% had received radiation to the head and neck before development of differentiated thyroid carcinoma. Eighteen patients underwent preoperative needle biopsy of a neck mass, and in 16 (89%) a definite result was reported. In this group of 18, the needle biopsy result was positive in 13
Discussion
One of the most striking attributes of pediatric differentiated thyroid cancer is the fact that death from progressive disease is very uncommon over long periods of follow-up.1, 3, 4, 11, 12, 13, 14, 15, 16, 17 Shah et al,18 in a report of 973 patients with differentiated thyroid cancer, noted that size, patient age, extrathyroidal extension, histology, and distant metastases were the only independent prognostic factors in multivariate analysis. The average age in this series was 43 years. In
References (26)
- et al.
Prognostic factors in differentiated carcinoma of the thyroid gland
Am J Surg
(1992) - 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) - et al.
Differentiated thyroid carcinoma in children and adolescents: A 37-year experience in 85 patients
J Nucl Med
(1997) - et al.
Recurrence and morbidity in differentiated thyroid carcinoma in children
Surgery
(1988) - et al.
Differentiated thyroid carcinoma in childhood: Long term follow-up of 72 patients
J Clin Endocrinol Metab
(1987) - et al.
Clinical features associated with metastasis and recurrence of differentiated thyroid cancer in children, adolescents and young adults
Clin Endocrinol (Oxf)
(1998) - et al.
Late prognosis of childhood and juvenile thyroid carcinomas
Prog Pediatr Surg
(1991) - et al.
Clinical features associated with metastasis and recurrence of differentiated thyroid cancer in children, adolescents and young adults
Clin Endocrinol (Oxf)
(1998) - et al.
Long-term results of treatment of 283 patients with lung and bone metastases from differentiated thyroid carcinoma
J Clin Endocrinol Metab
(1986) - et al.
Radioiodine treatment of metastatic thyroid carcinoma: The Royal Marsden Hospital experience
Brit J Radiol
(1984)
Nonparametric estimation from incomplete observations
J Am Stat Assoc
Long-term results and prognostic factors in patients with differentiated thyroid carcinoma
Cancer
The current management of thyroid tumors in childhood
Semin Pediatr Surg
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Grant support from the Division of Cancer Treatment, National Cancer Institute, National Institutes of Health, Department of Health and Human Services (CA 13539).
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Address reprint requests to Michael P. La Quaglia, MD, Children's Cancer Group, PO Box 60012, Arcadia, CA 91066-6012.