Differentiated Thyroid Cancer in Children in the Last 20 Years: A Regional Study in Romania

Area of Science:

• Pediatric Endocrinology
• Oncology
• Nuclear Medicine

Background:

• Pediatric thyroid carcinoma lacks specific guidelines, often relying on adult protocols.
• Environmental factors, including Chernobyl fallout and iodine deficiency, may influence pediatric thyroid cancer incidence and characteristics.
• Existing research on pediatric thyroid cancer is limited, necessitating further investigation.

Purpose of the Study:

• To retrospectively analyze the clinical presentation, diagnosis, treatment, complications, and outcomes of pediatric thyroid cancer patients.
• To compare findings with historical data from the same institution and a non-Chernobyl exposed cohort.
• To evaluate the impact of specific environmental factors on pediatric thyroid cancer in Romania.

Main Methods:

• Retrospective analysis of 62 pediatric thyroid cancer patients diagnosed between 2000-2018.
• Statistical comparison with previous institutional data (1991-2010) and a Dutch cohort (1970-2013).
• Review of patient demographics, tumor characteristics, treatment modalities (including radioiodine), and survival rates.

Main Results:

• Papillary thyroid carcinoma was the predominant subtype, with an observed incidence of thyroid microcarcinoma in children.
• 85.4% of patients received radioiodine therapy, with significantly lower total activity compared to literature.
• Excellent prognosis was observed, with a 100% overall survival rate in the study cohort.

Conclusions:

• Pediatric thyroid cancer in this Romanian cohort demonstrates an excellent prognosis with appropriate management.
• Lower radioiodine activity may be effective in pediatric cases, warranting further research.
• The study highlights the importance of tailored approaches for pediatric thyroid cancer, considering regional environmental factors.