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Minimal Invasive Resection of Large Retrosternal Thyroid Goiter
Published on: September 20, 2024
Outcomes of surgically managed pediatric thyroid cancer
Anna E Bargren1, Goswin Y Meyer-Rochow, Leigh W Delbridge
1Section of Endocrine Surgery, Department of Surgery, University of Wisconsin, Madison, WI 53792, USA.
Insights
Pediatric thyroid cancer management via total thyroidectomy is recommended. While surgical complications were similar across procedures, less-than-total thyroidectomies increased the risk of repeat surgeries for children.
Area of Science:
- Pediatric Surgery
- Endocrine Surgery
- Oncology
Background:
- Thyroid cancer is the most common childhood carcinoma, often presenting at a more advanced stage than in adults.
- Current management for pediatric and adult thyroid cancer is similar, predominantly involving total thyroidectomy.
- The study aimed to evaluate surgical outcomes specifically in pediatric patients with thyroid malignancy.
Purpose of the Study:
- To investigate the surgical outcomes of pediatric patients undergoing treatment for thyroid malignancy.
- To compare complication rates and the need for reoperation based on surgical approach in children with thyroid cancer.
Main Methods:
- A retrospective review of medical records was conducted for 68 pediatric patients (<19 years) who underwent surgical resection of a malignant thyroid nodule.
- Data were collected from two academic institutions between 1962 and 2008.
Main Results:
- Total thyroidectomy was performed in 74% (50/68) of pediatric patients.
- Minor complications occurred in 21% of surgeries, with temporary hypocalcemia in 19%.
- Patients undergoing lobectomy or subtotal thyroidectomy had a higher risk (21%) of requiring a second surgical procedure compared to total thyroidectomy.
Conclusions:
- The type of surgery did not significantly impact the risk of surgical complications in pediatric thyroid cancer.
- Less than total thyroidectomy was associated with an increased risk of repeat surgery.
- Total thyroidectomy is recommended as the standard of care for managing pediatric thyroid cancer due to lower reoperation rates.
Background:
Thyroid cancer is the most common carcinoma in children, and compared with adults, generally present with more advanced disease. Management is similar between populations, primarily consisting of total thyroidectomy. With similar treatment despite disease severity, we chose to explore the surgical outcome of pediatric patients with thyroid malignancy.
Methods:
A review of medical records at two academic institutions revealed 68 patients<19 y of age who underwent surgical resection of a malignant thyroid nodule between 1962 and 2008.
Results:
Of 68 pediatric surgery patients identified with thyroid malignancy, 50 patients (74%) had a total thyroidectomy. Minor complications were noted in 21% of surgeries with 19% temporary hypocalcemia. Risk of complication was not associated with type of surgery. Patients receiving a lobectomy or subtotal thyroidectomy were at greater risk for needing a second surgical procedure, required by 14 patients (21%).
Conclusions:
There was no significant increase in surgical complications with respect to type of surgery, however, patients receiving less than total thyroidectomy were at increased risk of repeat surgery. Total thyroidectomy is recommended as the standard of care for the management of pediatric thyroid cancer.
