Age Stratification and Prognostic Factor Analysis in Pediatric Differentiated Thyroid Cancer

Area of Science:

• Pediatric Endocrinology
• Oncology
• Cancer Research

Background:

• Differentiated thyroid cancer (DTC) is uncommon in children.
• The relationship between age at diagnosis and disease aggressiveness in pediatric DTC is not fully understood.
• Identifying prognostic factors is crucial for tailoring treatment and improving outcomes.

Purpose of the Study:

• To identify prognostic factors for aggressive pediatric DTC.
• To define appropriate age stratification for risk assessment in pediatric DTC.
• To evaluate the impact of age on disease aggressiveness and treatment outcomes.

Main Methods:

• Retrospective cohort study of pediatric patients (≤18 years) treated for DTC between 1985 and 2021.
• Minimum follow-up of 1.5 years post-treatment.
• Analysis of American Thyroid Association (ATA) risk stratification, histopathologic features, and disease progression by age.

Main Results:

• Younger patients (<11 years) showed more aggressive disease features, including higher ATA risk and metastatic disease.
• Children under 11 had a significantly higher rate of disease evidence at 1 year post-treatment (66.7% vs. 25.4%).
• Patients under 8 years had more frequent bilateral disease and extrathyroidal extension.

Conclusions:

• Pediatric DTC patients diagnosed before age 11 present with more aggressive disease and lower early remission rates.
• Despite initial challenges, long-term outcomes for pediatric DTC patients are generally satisfactory.
• Age at diagnosis is a significant factor influencing disease behavior in pediatric DTC.