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KMID : 0356820200360020009
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Korean Journal of Head & Neck Oncology
2020 Volume.36 No. 2 p.9 ~ p.15
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Age and Tumor Size is a Prognostic Factor in Pediatric/Adolescent Differentiated Thyroid Carcinoma
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Byun Byung-Hyun
Lee Guk-Haeng
Kim Dong-Ho
Lim Jung-Sub
Lim Il-Han
Lim Sang-Moo
Lee Byeong-Cheol
Lee Jun-Ah
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Abstract
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Background/Objectives: To analyze the clinical characteristics of differentiated thyroid cancer (DTC) in children and adolescents.
Materials & Methods: Medical records of 31 DTC cases that were diagnosed and treated at Korea Cancer Center Hospital between 2002 and 2018 were retrospectively reviewed.
Results: Most cases were papillary carcinoma (n=26), with female predominance (n=25). Median age was 16.4 years (range, 11.9-18.6 years). Extrathyroidal extension was present in 24 cases. Twenty cases had tumor involvement at cervical lymph nodes and three had lung metastasis. Twenty-two patients received radioactive iodide treatment with a median cumulative dose of 300 mCi (range, 100-920 mCi). During a median follow-up of 68.2 months (range, 2.3-191.4 months), serum thyroglobulin level was elevated in 15 patients. Among them, two cases had remnant thyroid tissue, 4 had recurrence at cervical lymph nodes, and the remaining 9 did not have any detectable lesion. All were alive, and 5-year event-free survival (EFS) was 45.2±10.1%. Age ￡15 years, tumor size, lymph node status (N1b), and distant metastasis had negative effects on EFS. On multivariate analysis, age and tumor size had prognostic significance.
Conclusion: For DTC of children and adolescents (￡18 years old), age ≤15 years and tumor size were prognostic factor. Therefore, patients in this age group need meticulous follow-up. Further studies are necessary to answer the potential influence of age on the incidence and behavior of DTC.
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KEYWORD
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Thyroid carcinoma, Children, Adolescent, Prognosis
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