Related Experiment Videos
Age is the major determinant of recurrence in pediatric differentiated thyroid carcinoma
A J Alessandri1, K J Goddard, G K Blair
1Department of Paediatrics, Division of Hematology/Oncology/Bone Marrow Transplantation, University of British Columbia and British Columbia's Children's Hospital, Vancouver, Canada.
Insights
Younger children diagnosed with differentiated thyroid carcinoma have a higher risk of recurrence. Age at diagnosis is the primary factor influencing recurrence, suggesting unique tumor biology in younger patients.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Cancer Research
Background:
- Pediatric differentiated thyroid carcinoma (PDTC) recurrence risk is linked to young age.
- Prognostic factors and treatment efficacy in very young children with PDTC remain understudied.
Purpose of the Study:
- To evaluate the association between age and outcome in pediatric differentiated thyroid carcinoma.
- To compare clinical, pathologic, prognostic, and treatment variables between younger and older children with PDTC.
Main Methods:
- Retrospective review of patients under 17 years old diagnosed with PDTC between 1955 and 1996.
- Analysis of clinical, pathologic, prognostic, and treatment variables.
Main Results:
- Age at diagnosis was the sole determinant of recurrence risk (P = 0.022).
- Twenty-year relapse-free survival was significantly lower for children ≤10 years (10.1%) compared to those >10 years (48.3%).
- Younger age correlated with extrathyroidal tumor invasion, but this did not independently predict outcome.
Conclusions:
- Age is the primary determinant of recurrence in pediatric differentiated thyroid carcinoma.
- Younger children exhibit distinct tumor biology, necessitating novel therapeutic strategies to reduce recurrence rates.
Background:
A relationship between young age and increased risk of recurrence of pediatric differentiated thyroid carcinoma has been suggested; however, no attempts have been made to assess the prognostic factors or efficacy of treatment in very young children with this malignancy. The objectives of this study were to evaluate the association of age with outcome in pediatric differentiated thyroid carcinoma and to compare the clinical, pathologic, prognostic, and treatment variables between younger and older children with this disease.
Procedure:
A retrospective review of all patients presenting to the British Columbia's Children's Hospital or British Columbia Cancer Agency <17 years of age at diagnosis with differentiated thyroid carcinoma between January, 1955, and December, 1996, was completed.
Results:
Thirty-eight patients were identified, 12 of whom were 10 years. An association between young age and extrathyroidal tumor invasion was identified (P = 0.016); however, the latter factor did not independently predict outcome. There was a trend for suppressive doses of thyroid hormone to improve outcome, particularly with increasing age at diagnosis, but this was not statistically significant.
Conclusions:
Age is the major determinant of recurrence in pediatric differentiated thyroid carcinoma. The results suggest different tumor biology in young children requiring novel approaches to therapy to decrease recurrence rates.