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Pediatric papillary thyroid carcinoma: outcomes and survival predictors in 2504 surgical patients
Samuel Golpanian1, Eduardo A Perez1, Jun Tashiro1
1Division of Pediatric Surgery, DeWitt Daughtry Family, Department of Surgery, University of Miami Miller School of Medicine, 1120 N.W. 14th Street, Suite 450J, Miami, FL, 33136, USA.
Insights
Pediatric papillary thyroid cancer incidence is rising, particularly in females. Survival rates remain high across all tumor sizes and surgical procedures, with no significant difference based on surgical approach.
Area of Science:
- Oncology
- Pediatric Endocrinology
- Surgical Oncology
Background:
- Pediatric thyroid carcinoma, particularly papillary thyroid carcinoma (PTC), requires understanding of epidemiological trends and survival predictors.
- Incidence and outcomes in pediatric PTC have been less studied compared to adult populations.
Purpose of the Study:
- To evaluate the incidence, clinical characteristics, and survival outcomes of pediatric papillary thyroid carcinoma.
- To identify predictors of survival in young patients diagnosed with papillary thyroid cancer.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database to identify pediatric cases (≤20 years) of papillary thyroid carcinoma diagnosed between 1973 and 2011.
- Analyzed demographic, clinical, and survival data using standard statistical methods, including all papillary types and follicular variants.
- Compared surgical procedures (lobectomy/isthmusectomy vs. subtotal/total thyroidectomy) and their association with tumor characteristics and outcomes.
Main Results:
- Identified 2504 cases, with an incidence of 0.483/100,000 persons/year, showing a significant annual increase of 2.07%.
- Mean age at diagnosis was 16 years, with higher incidence in white females aged 15-19. Tumors ≥1 cm were more likely to be lymph node-positive and associated with subtotal/total thyroidectomy.
- Disease-specific 30-year survival ranged from 99-100%, irrespective of tumor size or surgical procedure; mortality did not differ between procedures, and lymph node sampling did not impact survival.
Conclusions:
- The incidence of pediatric papillary thyroid cancer is increasing, with a higher prevalence in females who exhibit similar survival rates to males.
- Tumor size ≥1 cm is a significant predictor of lymph node positivity and influences surgical approach, but does not negatively impact high survival rates.
- Surgical procedure choice for pediatric papillary thyroid cancer does not affect survival outcomes, emphasizing the generally favorable prognosis for this condition.
Objective:
To evaluate outcomes and predictors of survival of pediatric thyroid carcinoma, specifically papillary thyroid carcinoma.
Methods:
SEER was searched for surgical pediatric cases (≤20 years old) of papillary thyroid carcinoma diagnosed between 1973 and 2011. Demographics, clinical characteristics, and survival outcomes were analyzed using standard statistical methods. All papillary types, including follicular variant, were included.
Results:
A total of 2504 cases were identified. Overall incidence was 0.483/100,000 persons per year with a significant annual percent change (APC) in occurrence of 2.07 % from baseline (P < 0.05). Mean age at diagnosis was 16 years and highest incidence was found in white, female patients ages 15-19. Patients with tumor sizes <1 cm more likely received lobectomies/isthmusectomies versus subtotal/total thyroidectomies [OR = 3.03 (2.12, 4.32); P < 0.001]. Patients with tumors ≥1 cm and lymph node-positive statuses [OR = 99.0 (12.5, 783); P < 0.001] more likely underwent subtotal/total thyroidectomy compared to lobectomy/isthmusectomy. Tumors ≥1 cm were more likely lymph node-positive [OR = 39.4 (16.6, 93.7); p < 0.001]. Mortality did not differ between procedures. Mean survival was 38.6 years and higher in those with regional disease. Disease-specific 30-year survival ranged from 99 to 100 %, regardless of tumor size or procedure. Lymph node sampling did not affect survival.
Conclusions:
The incidence of pediatric papillary thyroid cancer is increasing. Females have a higher incidence, but similar survival to males. Tumors ≥1 cm were likely to be lymph node-positive. Although tumors ≥1 cm were more likely to be resected by subtotal/total thyroidectomy, survival was high and did not differ based on procedure.
