Paediatric differentiated thyroid carcinoma: a UK National Clinical Practice Consensus Guideline

Area of Science:

• Pediatric Endocrinology
• Oncology
• Clinical Guidelines

Background:

• Differentiated thyroid carcinoma (DTC) in pediatric patients presents unique challenges compared to adults.
• Recent advancements in care pathways necessitate updated management strategies for pediatric DTC.
• Existing guidelines may not fully address the specific needs of children and adolescents with DTC.

Purpose of the Study:

• To establish a comprehensive, evidence-based guideline for managing pediatric patients (up to 19 years) with differentiated thyroid carcinoma.
• To synthesize current scientific evidence and expert opinion into pragmatic clinical recommendations.
• To improve the quality of care and clinical decision-making for pediatric thyroid cancer.

Main Methods:

• Systematic primary literature review conducted by a multi-disciplinary expert panel.
• Delphi Consensus exercise to achieve agreement on management strategies.
• Adherence to The Appraisal of Guidelines Research and Evaluation (AGREE II) instrument criteria.

Main Results:

• Development of 58 distinct recommendations for the management of pediatric differentiated thyroid carcinoma.
• Guidelines encompass presentation, clinical assessment, diagnosis, surgical and medical management, genetic counseling, follow-up, and prognosis.
• Integration of scientific evidence with expert clinical judgment.

Conclusions:

• This guideline offers a clear, pragmatic framework for clinicians managing pediatric differentiated thyroid carcinoma.
• It serves as an evidence base to optimize future management and enhance clinical care quality.
• The guideline addresses key differences in pediatric versus adult DTC care and incorporates recent developments.