Clinical characteristics and treatment of thyroid cancer in children and adolescents: a retrospective analysis of 83 patients

J Zhejiang Univ Sci B. 2017 May;18(5):430-436. doi: 10.1631/jzus.B1600308.

Abstract

Objective: To study the clinical characteristics, treatment, and prognosis of thyroid cancer in children and adolescents.

Methods: We performed a retrospective analysis of clinical data from 83 cases of thyroid cancer in children and adolescents from January 1990 to December 2010. We compared extra-thyroid extension, lymph node metastasis, distant metastasis, and prognosis between pediatric patients ≤12 years of age (27 cases) and those >12 years of age (56 cases). All the patients agreed to undergo thyroidectomy and endocrine therapy, and the consent was obtained from parents or guardians.

Results: Histopathology included papillary carcinoma in 67 cases, papillary carcinoma with partial follicular growth pattern in 1 case, papillary carcinoma with squamous metaplasia in 4 cases, follicular carcinoma in 7 cases, medullary carcinoma in 3 cases, and poorly differentiated carcinoma in 1 case. The total lymph node metastasis rate was 78.31%. Patients ≤12 years of age showed a higher rate of lymph node metastasis than the older group (92.59% vs. 71.43%, P=0.028). The incidence rate in females in the older group was higher than that in the younger group (80.36% vs. 59.26%, P=0.041). There were no significant differences in extra-thyroid extension, distant metastasis, survival rate, or recurrent disease between the two groups.

Conclusions: The lymph node metastasis of thyroid cancer is higher in patients ≤12 years of age than in those >12 years of age; the incidence rate is higher in females than in males. Childhood thyroid cancer has a good prognosis, surgery being the most effective treatment. Choosing a reasonable surgery method and comprehensive postoperative treatment can achieve a cure and satisfactory survival rate.

Keywords: Children and adolescents; Thyroid cancer; Clinical characteristics; Surgical treatment.

MeSH terms

  • Adolescent
  • Age Distribution
  • Child
  • Child, Preschool
  • China / epidemiology
  • Diagnosis, Differential
  • Female
  • Hormone Replacement Therapy / mortality*
  • Hormone Replacement Therapy / statistics & numerical data
  • Humans
  • Infant
  • Infant, Newborn
  • Lymphatic Metastasis
  • Male
  • Prevalence
  • Risk Factors
  • Sex Distribution
  • Survival Rate
  • Symptom Assessment / methods*
  • Thyroid Neoplasms / diagnosis*
  • Thyroid Neoplasms / mortality
  • Thyroid Neoplasms / therapy*
  • Thyroidectomy / mortality*
  • Thyroidectomy / statistics & numerical data
  • Treatment Outcome