Risk-adapted therapy in pediatric thyroid cancer: initial experience from a national reference program by the MET...

Area of Science:

• Endocrinology
• Pediatric Oncology
• Cancer Registry Studies

Background:

• Pediatric differentiated thyroid carcinoma (pedDTC) is rare but increasing.
• Multidisciplinary care is crucial for optimal pedDTC outcomes.
• A German national reference program was established in 2021 to standardize pedDTC management, focusing on radioactive iodine (RAI) use and treatment variability.

Purpose of the Study:

• To evaluate the initial 3.5 years of the German national reference program for pediatric differentiated thyroid carcinoma.
• To analyze demographic trends, therapeutic decisions, and short-term outcomes in patients managed through the program.
• To assess the impact of a structured, individualized, and risk-adapted approach to pedDTC care.

Main Methods:

• Analysis of 43 inquiries concerning 39 patients with confirmed or suspected pedDTC over 3.5 years.
• Weekly national expert tumor board providing multidisciplinary, individualized recommendations.
• Data analysis of demographic trends, therapeutic decisions, and short-term outcomes.

Main Results:

• In 34 confirmed pedDTC patients, RAI was reduced or omitted in 70.6%, especially in low-risk cases.
• Surgical strategies were modified in 61.5% of cases to balance efficacy and morbidity.
• All patients were alive at a mean follow-up of 0.7 years, with 15.4% persistent disease.

Conclusions:

• The German national reference program successfully implemented a structured, individualized management approach for pedDTC.
• This centralized, risk-adapted model shows promise in optimizing care for pediatric thyroid cancer.
• Long-term follow-up data are needed to fully assess the program's impact.