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Evaluation of Prognosis of Juvenile Differentiated Thyroid Carcinoma
Takahiro Tsukioki1, Tadahiko Shien1, Yusuke Ohtani1
1Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama 700-8558, Japan.
Insights
Juvenile differentiated thyroid carcinoma (DTC) presents aggressively but has an excellent prognosis. This study found no specific factors predicting recurrence in young patients, highlighting the need for further research into risk factors.
Area of Science:
- Oncology
- Pediatric Endocrinology
- Surgical Oncology
Background:
- Differentiated thyroid carcinoma (DTC) in juvenile patients often presents as extensive and aggressive disease.
- Despite aggressive presentation, juvenile DTC generally has an excellent prognosis with low mortality rates, even in advanced stages.
- Uncertainty remains regarding prognostic factors and optimal treatment strategies for this population.
Purpose of the Study:
- To retrospectively investigate the prognosis and identify potential risk factors for differentiated thyroid carcinoma (DTC) in juvenile patients.
- To analyze factors including sex, discovery method, treatment details, and pathological findings in relation to DTC outcomes in young individuals.
- To clarify risk factors influencing recurrence and long-term survival in juvenile DTC.
Main Methods:
- Retrospective analysis of 33 juvenile patients (< 30 years old) diagnosed with DTC between April 2004 and March 2017.
- All patients underwent curative surgical treatment.
- Evaluation of pathological factors such as lymph node metastasis (including bilaterality and number of metastatic nodes), and assessment of treatment progress and recurrence.
Main Results:
- Lymph node metastasis was prevalent, found in 75% of patients, with 39% having bilateral cervical metastasis and 27% having over 10 metastatic lymph nodes.
- Two patients with over 20 metastatic lymph nodes received radioactive iodine (RAI) therapy.
- Five patients (15%) experienced local recurrences, treated with surgery and/or RAI, with no subsequent recurrences or deaths observed in the cohort.
Conclusions:
- Juvenile differentiated thyroid carcinoma (DTC) demonstrates a high frequency of lymph node metastasis but an excellent survival rate.
- No specific factors were identified as significant predictors of recurrence in this cohort of young DTC patients.
- Local recurrent disease is effectively managed with surgery and/or RAI, leading to excellent survival outcomes in juvenile DTC.
Abstract:
Differentiated thyroid carcinoma (DTC) in juvenile patients is often an extensive and aggressive disease with a high frequency of recurrence. However, the prognosis is excellent, with a low mortality rate even when advanced disease is present, although prognostic factors and treatment strategy remain uncertain. Between April 2004 and March 2017, 33 juvenile patients (< 30 years old) were diagnosed with DTC and treated at our institution. We retrospectively investigated prognosis and factors including sex, reason for discovery, treatment, pathological factors and treatment progress to clarify the risk factors. All patients underwent curative surgical treatment. Pathologically, lymph node metastasis was identified in 25 patients (75%). Thirteen patients (39%) had bilateral cervical metastasis. In addition, 9 (27%) had more than 10 metastatic lymph nodes. The 2 patients with more than 20 metastatic lymph nodes were treated with radioactive iodine (RAI). Five patients (15%) had local recurrences and received surgery. There have been no further recurrences or deaths. However, no factors were determined to significantly predict the recurrence of juvenile DTC. Local recurrent disease was treated with surgery and/or RAI until remission, and survival was excellent in juvenile DTC.
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