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[Differentiated thyroid carcinoma in young people]
Chuan-zheng Sun1, Fu-jin Chen, Zong-yuan Zeng
1Departmemt of Head and Neck Surgery, Cancer Center, SUN Yat-sen University, Guangzhou 510060, China.
Summary
Distant metastasis, tumor size, and age significantly impact survival in young differentiated thyroid carcinoma (DTC) patients. Surgical treatment with TSH suppressive therapy is effective for DTC without distant metastasis, but prognosis is poor for those with metastasis.
Area of Science:
- Endocrinology
- Surgical Oncology
- Pediatric Oncology
Context:
- Differentiated thyroid carcinoma (DTC) is rare in individuals under 30.
- Treatment strategies and prognostic factors in young DTC patients require specific investigation.
- Long-term outcomes for this demographic are crucial for optimizing care.
Purpose:
- To identify factors influencing survival in young patients diagnosed with DTC.
- To evaluate the efficacy of unilateral lobectomy, isthmectomy, cervical lymph node dissection, and TSH suppressive therapy.
- To analyze the impact of age, tumor characteristics, and metastasis on prognosis.
Summary:
- A retrospective review of 131 patients under 30 with DTC treated between 1985 and 1997.
- Multivariate analysis using the Cox proportional hazard model identified distant metastasis, tumor size, and age at diagnosis as independent predictors of survival.
- The 10-year survival rate was 97.18%, with significant differences based on age, tumor size, and presence of distant metastasis.
Impact:
- Age at diagnosis, tumor size, and distant metastasis are critical independent prognostic factors for young DTC patients.
- Surgical management including unilateral lobectomy, isthmectomy, and lymph node dissection, followed by TSH suppressive therapy, offers a favorable prognosis for patients without distant metastasis.
- Patients with distant metastasis face a significantly poorer prognosis despite this treatment model, highlighting the need for alternative therapeutic approaches.