Differentiated Thyroid Cancer Long-Term Outcomes and Risk Stratification in Pediatric and Adolescent Patients: A 44-Year Retrospective Study

Marko Buta ^1,2, Nada Santrac ^1,2, Merima Goran ^1,2

⁰School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia.

Diagnostics (basel, Switzerland) +

|

February 26, 2025

View abstract on PubMed

Summary

Risk stratification for pediatric differentiated thyroid cancer (DTC) identified key prognostic factors. Low-risk patients with DTC may benefit from less aggressive treatment, improving outcomes.

Area Of Science

Pediatric Oncology
Endocrinology
Cancer Research

Background

Differentiated thyroid cancer (DTC) in pediatric patients is rare but significant.
Pediatric DTC often presents at advanced stages but has favorable long-term outcomes.
Current management aims to optimize treatment and follow-up strategies.

Purpose Of The Study

To identify prognostic factors for DTC in patients aged 21 and younger.
To develop a risk stratification model for pediatric DTC.
To identify low-risk patients suitable for less radical treatment approaches.

Main Methods

Retrospective cohort study of 99 patients (children and adolescents) with DTC.
Data collected from 1980 to 2024.
Multivariate regression analysis to identify independent predictors of adverse events and event-free interval (EFI).

Main Results

No significant difference in long-term outcomes between children and adolescents.
More than 10.5 positive lymph nodes and extrathyroidal tumor extension are independent predictors of adverse events and reduced EFI.
Risk stratification into low-, intermediate-, and high-risk groups showed significant differences in EFI, with no low-risk patients experiencing disease recurrence.

Conclusions

Meticulous risk stratification is crucial for predicting DTC outcomes in pediatric patients.
The identified prognostic factors can guide personalized therapeutic strategies.
Distinguishing low-risk DTC patients may allow for less aggressive treatment, while high-risk patients require intensified management.

Keywords:

adolescents children differentiated thyroid cancer long-term outcomes prognostic factors risk stratification

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