Related Experiment Video
Updated: Feb 7, 2026
Transoral Robotic Total Thyroidectomy and Bilateral Central Regional Lymph Node Dissection for Papillary Thyroid Carcinoma
Published on: September 15, 2023
Risk prediction in children and adults less than 45 years old with papillary thyroid cancer
Agathoklis Konstantinidis1, Elizabeth Tracy1, Julie Ann Sosa1
1a Department of Surgery , Duke University Medical Center , Durham , NC , USA.
Insights
Papillary thyroid cancer is rising in young patients. This review covers risk factors like age, disease extent, and molecular markers to improve outcomes and reduce recurrence in this population.
Area of Science:
- Oncology
- Endocrinology
- Surgical Oncology
Background:
- Papillary thyroid cancer incidence is rapidly increasing in pediatric and young adult populations.
- Younger patients face distinct challenges, including higher risks of short-term complications and disease recurrence despite generally favorable long-term prognoses.
Purpose of the Study:
- To review the latest determinants of recurrence risk and compromised outcomes in young patients with papillary thyroid cancer.
- To synthesize current data on factors influencing prognosis and guide management strategies for this demographic.
Main Methods:
- Comprehensive literature review focusing on recent studies and expert commentary.
- Analysis of determinants including patient age, disease extent, dynamic staging, molecular markers, surgical factors, and novel therapies.
Main Results:
- Patient age, extent of disease, and dynamic staging are crucial for assessing recurrence risk.
- Molecular markers indicate tumor aggressiveness, while surgical resection adequacy and surgeon volume impact outcomes.
- Novel therapies are emerging for advanced, non-resectable disease.
Conclusions:
- Young patients with papillary thyroid cancer require careful evaluation of disease characteristics and treatment factors.
- Multidisciplinary collaboration among specialists is essential for optimizing patient outcomes.
- Emerging data may reshape current staging and risk-adjustment strategies for this group.
Introduction:
The incidence of papillary thyroid cancer is increasing faster than any other cancer in young patients. The purpose of this review is to discuss the most recent determinants of risk of recurrence and compromised outcomes in this population. Areas covered: This review discusses the most updated data on patient age, including children and young adults, extent of disease and subsequent dynamic staging over time, molecular markers for disease aggressiveness, adequacy of surgical resection and surgeon volume, and novel therapies for advanced non-resectable disease as predictors of patient outcomes. Expert commentary: Young patients enjoy excellent outcomes, with long-term survivorship, but face higher risks of short-term complications and disease recurrence. Thoughtful evaluation of the extent of disease, tumor features associated with more aggressive behavior, the presence of locoregional or distant metastases, and an understanding of molecular changes in their tumors are important areas of consideration. High-volume surgeons should work collaboratively with endocrinologists, radiologists, and pathologists specializing in thyroid cancer to help patients achieve excellent outcomes. Emerging data challenging the status quo regarding the relative importance of patient age, tumor features, and dynamic risk-adjustment for overall prognosis of these patients will likely impact future care and staging systems.
Related Concept Videos
01:11Papillary Dermis
The dermis might be considered the "core" of the integumentary system, as distinct from the epidermis and hypodermis. It contains blood and lymph vessels, nerves, and other structures, such as hair follicles and sweat glands. The dermis is made of two layers of connective tissue that comprise an interconnected mesh of elastin and collagenous fibers, produced by fibroblasts.
Papillary Layer
The papillary layer is made of loose, areolar connective tissue, which means the collagen...
01:23The Thyroid Gland
The follicles have a central cavity lined by simple cuboidal to squamous epithelial cells called follicular cells. These cells produce the glycoprotein...
02:27Predicting Molecular Geometry
01:12Relative Risk
01:18Functions of Thyroid Hormones
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
01:03Prediction Intervals
However, the point estimate is most likely not the exact value of the population parameter, but close to it. After calculating point estimates, we construct interval estimates, called confidence intervals or prediction intervals. This prediction interval comprises a range of values unlike the point estimate and is a better predictor of the observed sample value, y.