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Pediatric Thyroid Cancer: To Whom Do You Send the Referral?
Allison Keane1, Darrin V Bann1, Meghan N Wilson1
1Milton S. Hershey Medical Center, Department of Otolaryngology-Head and Neck Surgery, Penn State Health, 500 University Drive, Hershey, PA 17033, USA.
Insights
Pediatric thyroid cancer surgery outcomes improve with surgeon subspecialty and high-volume experience. Developing specialized pediatric thyroid cancer centers and multidisciplinary teams enhances patient care.
Area of Science:
- Pediatric Surgery
- Endocrinology
- Surgical Oncology
Background:
- Pediatric thyroid cancer incidence is rising.
- Surgical intervention is the standard treatment for differentiated thyroid cancer in children.
- Multiple surgical specialties perform pediatric thyroidectomies.
Purpose of the Study:
- To review evidence on surgeon subspecialty and volume impact on pediatric thyroid cancer surgery outcomes.
- To identify optimal surgical approaches for pediatric thyroid cancer patients.
Main Methods:
- Comprehensive literature review.
- Analysis of studies on surgeon experience and patient outcomes in pediatric thyroid cancer.
Main Results:
- Pediatric general surgeons and pediatric otolaryngologists are the primary operators.
- High-volume surgeons correlate with lower complication rates, similar to adult data.
- Specific patient groups benefit from combined surgical approaches.
Conclusions:
- Surgeon subspecialty and high-volume surgical experience are critical for pediatric thyroid cancer outcomes.
- Further research is needed to define 'high-volume' for pediatric thyroidectomies.
- Dedicated pediatric thyroid cancer centers and multidisciplinary/dual-surgeon approaches are recommended.
Abstract:
Pediatric thyroid cancer is rare, but increasing in annual incidence. Differentiated thyroid cancer in pediatric patients is treated surgically. Pediatric thyroidectomies are performed by general surgeons, otolaryngologists, general pediatric surgeons, and pediatric otolaryngologists. In a comprehensive literature review, we discuss the evidence supporting the importance of surgeon subspecialty and surgeon volume on outcomes for pediatric thyroid cancer patients. Pediatric general surgeons and pediatric otolaryngologists perform most pediatric thyroidectomies. Certain subpopulations specifically benefit from a combined approach of a pediatric surgeon and a high-volume thyroid surgeon. The correlation between high-volume surgeons and lower complication rates in adult thyroid surgery applies to the pediatric population; however, the definition of high-volume for pediatric thyroidectomies requires further investigation. The development of dedicated pediatric thyroid malignancy centers and multidisciplinary or dual-surgeon approaches are advantageous.
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