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Published on: June 2, 2023
[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.
Insights
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.
Unlabelled:
It has been suggested a different biodevelopment in the differentiated thyroid cancer in pediatric age. General and pediatric surgeons from different centres has coincided to operate this kind of pediatric pathology that finally conclude the treatment in the nuclear medicine department from the reference hospital. The objectives of this revision is, to confirm de difference in thyroid cancer in pediatric age and to know few factors implicated.
Materials And Methods:
A review of 57 patients with differentiated thyroid cancer, medullary and anaplastic were excluded, treated in the nuclear medicine department during the last 20 years. 28% were < 10 years old (16 cases) and 72% > 10 years old (41 cases). This 57 young patients were operated in 22 hospitals and 79% by a general surgeon and 21% by pediatric surgeon. The analysis was performed with SPSS MS Windows 6.0 (chi cuadrado, t-Student-Fisher).
Results:
There are more reinterventions in patients operated by a general surgeon. There aren't differences between the number of total neck dissections between both groups of surgeons, but when is performed, the incidence of complications is significantly high. In patients < 10 years old, there are more metastasis and more surgical complications. In spite of, all patients still alive.
Conclusions:
Children < 10 years old, the illness is more local aggressive and the recurrence and lung metastasis is high, more surgical complications. We recommend to concentrate this pathology in a few hospitals to achieve more experience and to avoid complications.
