The 2015 American Thyroid Association guidelines and trends in hemithyroidectomy utilization for pediatric thyroid cancer

Head Neck. 2022 Aug;44(8):1833-1841. doi: 10.1002/hed.27098. Epub 2022 May 21.

Abstract

Background: In 2015, the American Thyroid Association (ATA) released its inaugural recommendations for the management of thyroid cancer in children. We aim to evaluate whether there has been a change in hemithyroidectomy utilization for pediatric differentiated thyroid cancer, and the association between those changes and the release of the ATA guidelines.

Methods: The National Cancer Database was queried and identified 4776 patients ≤18 years old with differentiated thyroid cancer. Causal impact time-series analysis and logistic analysis were utilized to assess factors associated with use of hemithyroidectomy.

Results: Post-2015 hemithyroidectomy rate was greater than predicted based on preguideline trends (predicted: 8.4%, actual: 12.6%, p = 0.001). In logistic analysis of factors associated with hemithyroidectomy use, we find that Papillary histology, tumor size >1 cm, nodal examination, and positive nodes were associated with lower rate of hemithyroidectomy (OR: 0.23, 0.51, 0.62, and 0.18, respectively).

Conclusion: There has been a significant increase in hemithyroidectomy utilization for pediatric differentiated thyroid cancer.

Keywords: American Thyroid Association; NCDB; hemithyroidectomy; pediatric thyroid cancer; thyroidectomy.

MeSH terms

  • Adenocarcinoma*
  • Adolescent
  • Child
  • Humans
  • Neoplasm Recurrence, Local / pathology
  • Retrospective Studies
  • Thyroid Neoplasms* / pathology
  • Thyroidectomy