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[Thyroid carcinoma:Experience 57 cases. Is there a different bio-development in pediatric age?]
P Abad1, V Martínez Ibáñez, P Galofré
1Departamento de Cirugía Pediátrica, Hospital Vall d'Hebron, Barcelona.
Summary
Pediatric differentiated thyroid cancer shows distinct characteristics in younger children, with higher rates of metastasis and surgical complications. Centralizing care in experienced centers can improve outcomes for these young patients.
Area of Science:
- Endocrinology
- Pediatric Surgery
- Oncology
Context:
- Differentiated thyroid cancer (DTC) in pediatric patients presents unique challenges compared to adults.
- Multicenter surgical management of pediatric DTC involves general and pediatric surgeons, with subsequent treatment in nuclear medicine departments.
- Previous studies suggest potential differences in DTC biodevelopment and outcomes based on age and surgical approach.
Purpose:
- To confirm age-related differences in pediatric differentiated thyroid cancer.
- To identify factors influencing the management and outcomes of pediatric DTC.
- To evaluate the impact of surgeon specialty and hospital volume on treatment results.
Summary:
- A review of 57 pediatric DTC patients (28% <10 years) treated over 20 years revealed significant differences based on age and surgical management.
- Patients operated on by general surgeons experienced more reinterventions. Younger children (<10 years) showed increased metastasis and surgical complications.
- Despite higher complication rates in younger patients, all survived; however, disease aggressiveness and recurrence were noted.
Impact:
- Highlights the more aggressive local behavior and higher metastatic potential of DTC in children under 10 years old.
- Suggests that concentrating pediatric DTC cases in specialized centers may lead to improved surgical outcomes and reduced complications.
- Emphasizes the need for experienced surgical teams and focused management strategies for pediatric thyroid cancer.