Dynamic Risk Stratification for Predicting Long-term Outcomes in Pediatric Differentiated Thyroid Cancers

Area of Science:

• Endocrinology
• Pediatric Oncology
• Thyroid Cancer Research

Background:

• The American Thyroid Association (ATA) recommends Dynamic Risk Stratification (DRS) for managing adult differentiated thyroid cancers (DTCs).
• The utility of DRS in pediatric DTCs requires validation to ensure its effectiveness in younger populations.

Purpose of the Study:

• To validate the applicability and predictive value of Dynamic Risk Stratification (DRS) in pediatric differentiated thyroid cancer (DTC).
• To assess the association between DRS and long-term disease-free survival (DFS) in children with DTC.

Main Methods:

• Retrospective analysis of pediatric DTC patients (age ≤18 years) with ≥5 years of follow-up.
• Classification of patients into DRS response categories (excellent, biochemical incomplete, structural incomplete).
• Univariate and multivariate analyses to identify factors influencing disease-free survival (DFS).

Main Results:

• 176 pediatric DTC patients were analyzed; 46.6% achieved excellent response, 31.8% biochemical incomplete, and 21.6% structural incomplete response.
• Ten-year DFS rate was 88.7%.
• Multivariate analysis revealed DRS as a significant independent predictor of DFS (P = .016).

Conclusions:

• Dynamic Risk Stratification (DRS) is a valid tool for predicting long-term outcomes in pediatric differentiated thyroid cancer (DTC), similar to its use in adults.
• DRS offers refined risk assessment beyond initial ATA stratification, supporting personalized management strategies for pediatric DTC.