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Comparison of differentiated thyroid carcinoma recurrence and its clinical features in children of different ages
Bin Ye1, Jun Shi1, Chenling Shen2
1Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Younger children with differentiated thyroid carcinoma (DTC) have a higher recurrence risk. Local invasion was more common in the recurrence group, indicating age is a key factor in DTC.
Area of Science:
- Pediatric Oncology
- Endocrinology
- Cancer Research
Background:
- Differentiated thyroid carcinoma (DTC) prevalence in children is rising.
- Clinical features and recurrence patterns in pediatric DTC, particularly in younger age groups, require further study.
Purpose of the Study:
- To investigate the clinical features and recurrence rates of pediatric DTC across different age groups.
- To identify age-related risk factors for DTC recurrence in children.
Main Methods:
- Retrospective analysis of 73 pediatric DTC cases diagnosed between 1998 and 2014.
- Patients were categorized into age groups: 5-9, 10-14, and 15-19 years at diagnosis.
- Comparison of clinical features, TNM stage, risk levels, and recurrence rates between age groups.
Main Results:
- The recurrence group had a lower mean age at diagnosis (10.6 years) compared to the non-recurrence group (12.6 years).
- Local invasion was the primary initial symptom in the recurrence group versus thyroid nodules in the non-recurrence group.
- DTC recurrence rates decreased with increasing age, with the youngest group (5-9 years) showing the highest risk and proportion of local invasion.
Conclusions:
- Younger age at diagnosis is a significant risk factor for DTC recurrence in children.
- The youngest pediatric patients with DTC exhibit a higher risk of recurrence and a greater likelihood of local invasion.
Abstract:
The prevalence of differentiated thyroid carcinoma (DTC) in children is increasing. However, the clinical features and recurrence of DTC in children in different age groups, especially those less than 14 years old, are not well studied. We retrospectively investigated 73 children diagnosed with DTC in our hospital between January 1998 and July 2014. Data were reviewed for different age groups based on the age at initial diagnosis: 5-9, 10-14, or 15-19 years. The mean age of the recurrence group (10.6±4.1 years) was lower than that of the non-recurrence group (12.6±6.2 years; P=0.004). The main symptom at initial diagnosis was local invasion in the recurrence group, but was thyroid nodules in the non-recurrence group (P<0.001). The recurrence and non-recurrence groups did not differ in TNM stage or risk level. However, according to our age classification, the American Thyroid Association pediatric risk level was significantly different in three age groups (P=0.024). The DTC recurrence rate in each age group decreased as the age of the children increased (P=0.011). Thus, a high risk of recurrence and a high proportion of local invasion cases were observed in the youngest age group, suggesting that younger age is an important risk factor for DTC recurrence in children.
