Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (3): 88-94.doi: 10.6040/j.issn.1673-3770.1.2020.039

Previous Articles     Next Articles

Clinical characteristics and risk factors for differentiated thyroid carcinoma in children

Jingrong, CHEN Chun, MA Yan, XIE Jin   

  1. Department of Otolaryngology & Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine / Ear Institute, Shanghai Jiaotong University School of Medicine / Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200092, China
  • Published:2020-06-29

PDF (PC)

230

Abstract: Objective The prevalence of differentiated thyroid cancer(DTC)has been increasing in children in recent years. Here, we have discussed the clinical characteristics of differentiated thyroid cancer(DTC)in children, and analyzed cases with recurrence. Methods We retrospectively investigated 50 children diagnosed with DTC at our hospital between January 1998 and July 2014. The clinical characteristics were compared for different age groups based on their age at initial diagnosis: pre-school group(≤ 7 years old)and school-age group(7-13 years old), and the clinical data of the recurrence and non-recurrence groups were also reviewed. The clinical features observed in this study included the TNM stage, and the AJCC recommended risk, recurrence, and metastasis. The Kaplan Meier method was used to evaluate the recurrence-free survival rate of all age groups. Results There was a significant difference between the pre-school and school-age groups in terms of local invasion(P=0.008). The proportion of local invasion in the pre-school group(6 cases, 42.6%)was higher than that in the school-age group(3 cases, 8.1%). There was a significant difference in the T stage between the two groups(χ2=12.584,P=0.028). The proportion of T2 in the school-age group was higher(19 cases, 51.4%)than that in the pre-school age group. Whereas the proportion of T4A in the pre-school age group was higher(5 cases, 38.5%)than that in the school-age group. The proportion of surgical complications in the pre-school group was significantly higher than that in the school-age group(χ2=9.632,P=0.008). The proportion of total thyroidectomy in the non-recurrence group was significantly higher than that in the recurrence group(85.7%, 53.3%)(χ2 = 11.227, P=0.004). Total thyroidectomy was found to reduce the recurrence risk of DTC in children. There was no significant difference in TNM and risk level between the recurrence group and the non-recurrence group. The total percentage of T1a, T1b and T2 was more than 50%, and the low-risk and medium-risk levels were 37.5% and 25%, respectively. More than half of the recurrence cases had a low TNM stage and low-risk level at the time of initial diagnosis. There was no significant difference in the postoperative recurrence rate of DTC in children(P>0.05). Discussion The proportion of local invasion, tumor stage, and surgical complications in patients with DTC in the pre-school group was higher than that in the school-age group. Age was found to be an important risk factor for children with DTC. More than half of the recurrence cases were low-risk at the time of initial diagnosis. Therefore, further study should be conducted regarding the risk assessment strategy of DTC recurrence in children. Understanding of the clinical characteristics of children with DTC should be improved so that appropriate treatment strategies can be implemented.

Key words: differentiated thyroid carcinoma, recurrence, recurrence-free survival, lymph node metastasis, preschool, pediatrics

CLC Number: 

  • R581
[1] Hogan AR, Zhuge Y, Perez EA, et al. Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients[J]. J Surg Res, 2009, 156(1): 167-172.
[2] Vergamini LB, Frazier AL, Abrantes FL, et al. Increase in the incidence of differentiated thyroid carcinoma in children, adolescents, and young adults: a population-based study[J]. J Pediatr, 2014, 164(6): 1481-1485.
[3] Wu XC, Chen VW, Steele B, et al. Cancer incidence in adolescents and young adults in the United States, 1992-1997[J]. J Adolesc Health, 2003, 32(6): 405-415.
[4] Liu L, Huang F, Liu B, et al. Detection of distant metastasis at the time of ablation in children with differentiated thyroid cancer: the value of pre-ablation stimulated thyroglobulin[J]. Journal of Pediatric Endocrinology and Metabolism, 2018, 31(7): 751-756.
[5] Lazar L, Lebenthal Y, Steinmetz A, et al. Differentiated thyroid carcinoma in pediatric patients: comparison of presentation and course between pre-pubertal children and adolescents[J]. J Pediatr, 2009, 154(5): 708-714.
[6] Hay ID, Gonzalez-Losada T, Reinalda M S, et al. Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008[J]. World journal of surgery, 2010, 34(6): 1192-1202.
[7] Handkiewicz-Junak D, Wloch J, Roskosz J, et al. Total thyroidectomy and adjuvant radioiodine treatment independently decrease locoregional recurrence risk in childhood and adolescent differentiated thyroid cancer[J]. J Nucl Med, 2007, 48(6): 879-888.
[8] Saraiva J, Ribeiro C, Melo M, et al. Thyroid carcinoma in children and young adults: retrospective review of 19 cases[J]. Acta Med Port, 2013, 26(5): 578-582.
[9] Sugino K, Nagahama M, Kitagawa W, et al. Papillary Thyroid Carcinoma in Children and Adolescents: Long-Term Follow-Up and Clinical Characteristics[J]. World J Surg, 2015, 39(9): 2259-2265.
[10] Kiratli PO, Volkan-Salanci B, Gunay EC, et al. Thyroid cancer in pediatric age group: an institutional experience and review of the literature[J]. J Pediatr Hematol Oncol, 2013, 35(2): 93-97.
[11] Markovina S, Grigsby PW, Schwarz JK, et al. Treatment approach, surveillance, and outcome of well-differentiated thyroid cancer in childhood and adolescence[J]. Thyroid, 2014, 24(7): 1121-1126.
[12] Lamartina L, Grani G, Arvat E, et al. 8th edition of AJCC/TNM staging system of thyroid cancer: what to expect[J]. Endocrine Related Cancer, 2018, 25(3): L7-L11.
[13] 胡亚美, 江申沈, 倪鑫, 等. 诸福棠实用儿科学[M]. 第8版. 北京: 人民卫生出版社, 2015.
[14] Rivkees SA, Mazzaferri EL, Verburg FA, et al. The treatment of differentiated thyroid cancer in children: emphasis on surgical approach and radioactive iodine therapy[J]. Endocr Rev, 2011, 32(6): 798-826.
[15] Alzahrani AS, Alkhafaji D, Tuli M, et al. Comparison of differentiated thyroid cancer in children and adolescents([16] Al-Qahtani KH, Tunio MA, Al Asiri M, et al. Clinicopathological features and treatment outcomes of differentiated thyroid cancer in Saudi children and adults[J]. J Otolaryngol Head Neck Surg, 2015, 44: 48.
[17] 贺青卿,庄大勇,魏金祥. 甲状腺乳头状癌外科治疗策略[J]. 山东大学耳鼻喉眼学报, 2011, 25(5): 7-10.
[18] 余济春. 分化型甲状腺癌颈淋巴结清扫术[J]. 山东大学耳鼻喉眼学报, 2016, 30(2): 10-12.
[19] Francis GL, Waguespack SG, Bauer AJ, et al. Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer[J]. Thyroid, 2015, 25(7): 716-759.
[20] 李树春, 李振东, 刘宏伟, 等. 青少年及儿童分化型甲状腺癌临床特征及治疗策略[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(6): 431-437.
[21] 秦晓山, 张浩, 张平, 等. 儿童及青少年分化型甲状腺癌75例临床分析[J]. 中华内分泌外科杂志, 2019, 13(4): 301-304.
[22] Wada N, Sugino K, Mimura T, et al. Pediatric differentiated thyroid carcinoma in stage I: risk factor analysis for disease free survival[J]. BMC Cancer, 2009, 9(1): 306.
[23] O'gorman CS, Hamilton J, Rachmiel M, et al. Thyroid cancer in childhood: a retrospective review of childhood course[J]. Thyroid, 2010, 20(4): 375-380.
[24] Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM[J]. Ann Surg Oncol, 2010, 17(6): 1471-1474.
[25] Demidchik YE, Saenko VA, Yamashita S. Childhood thyroid cancer in Belarus, Russia, and Ukraine after Chernobyl and at present[J]. Arq Bras Endocrinol Metabol, 2007, 51(5): 748-762.
[26] Livhits MJ, Pasternak JD, Xiong M, et al. Pre-Ablation Thyroglobulin and Thyroglobulin to Thyroid-Stimulating Hormone Ratio May Be Associated with Pulmonary Metastases in Children with Differentiated Thyroid Cancer[J]. Endocr Pract, 2016, 22(11): 1259-1266.
[27] Joseph KR, Edirimanne S, Eslick GD. Multifocality as a prognostic factor in thyroid cancer: A meta-analysis[J]. Int J Surg, 2018, 50: 121-125.
[28] Vuong HG, Duong UNP, Pham TQ, et al. Clinicopathological Risk Factors for Distant Metastasis in Differentiated Thyroid Carcinoma: A Meta-analysis[J]. World J Surg, 2018, 42(4): 1005-1017.
[1] CHEN Dongyan, QIAN Ye, WEI Dongmin, LI Wenming, XIA Tongliang, LEI Dapeng, PAN Xinliang. Clinical value of high-frequency ultrasound in the diagnosis of lymph node metastasis in hypopharyngeal squamous cell carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(5): 18-23.
[2] LONG Ting, LIU Yuwei, WANG Shengcai, ZHANG Jie, LI Yanzhen, ZHANG Xuexi, LIU Qiaoyin, LIU Zhiyong, SUN Nian, NI Xin. A clinical analysis on children with congenital pyriform sinus fistula treated through microscopic laryngoscopy with CO2 laser cauterization [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(1): 125-130.
[3] LI Jingjing, WU Xinxin, MAO Ning, ZHENG Guibin, MU Yakui, CHU Tongpeng, JIA Chuanliang, ZHENG Haitao, MI Jia, SONG Xicheng. CT-based radiomics nomogram for the preoperative prediction of central lymph node metastases of papillary thyroid carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2021, 35(4): 51-59.
[4] FAN Li, LI Yue, XU Ximing. Changes in and prognostic value of the inflammatory index before and after concurrent chemoradiotherapy for nasopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 36-41.
[5] PANG Zhenwen, HUANG Yufeng, YANG Aifang, ZENG Xianjie. Correlation between Preoperative neutrophil/lymphocyte ratio and lymph node metastasis in patients with laryngeal cancer [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 58-62.
[6] CHEN Haibing, WEI Ya'nan, XU Xiaoquan, CHEN Xi. Prediction of cervical lymph node metastasis in papillary thyroid cancer based on XGBoost artificial intelligence and enhanced computed tomography [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(3): 40-45.
[7] WANG Jiashuo, GUO Xing, YAN Aihui. Giant cyst formation from lymph node metastasis in papillary thyroid cancer: a case study [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(3): 111-113.
[8] NING Yudong, CAI Yongcong, SUN Ronghao, JIANG Jian, ZHOU Yuqiu, SHUI Chunyan, WANG Xu, ZHENG Wanghu,. Preliminary analysis of the anterior superior mediastinal lymph node metastasis in thyroid papillary carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(3): 120-124.
[9] XIE Shuhua, YANG Zhumei, LIU Huiru, DONG Jing. Value of NLR, LMR, and PLR in predicting chronic sinusitis recurrence after endoscopic sinus surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(1): 54-57.
[10] Huijun CHEN,Shenghua SONG,Han ZHOU,Weida DONG,Mingzhe QIAO,Xi CHEN,Jin XU,Ziping LIN,Guangqian XING. Preoperative platelet-lymphocyte ratio is an independent prognostic factor for laryngeal squamous cell carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 106-110.
[11] Yan JIANG. Recurrence of nasopharyngeal carcinoma and application of endoscopic surgery [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 1-11.
[12] Dongping CHEN,Zhihuan YANG,Yan ZHANG,Nan FANG,Bin QI. Status of surgical treatment for recurrent nasopharyngeal carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 12-16.
[13] Wenrui XU,Yan JIANG. Surgery Treatment for Recurrent Nasopharyngeal Carcinoma [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(2): 35-38.
[14] HAN Yang, YANG Xiaojian, TANG Lixing, WANG Pengpeng, ZHANG Jie, GE Wentong. Clinical features and treatment of juvenile ossifying fibroma of the nasal cavity and sinuses [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(6): 79-83.
[15] XU Shuhang, LI Chunrui, LIU Chao. Optimal management of differentiated thyroid carcinoma in children. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2017, 31(6): 12-15.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(2): 116 -118 .
[2] ZHOU Zi-ning,JIN Guo-wei . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(5): 462 -465 .
[3] ZHOU Bin,LI Bin . Endoscopic sinus surgery for 75 patients with chronic sinusitis and nasal polyps[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 24 -26 .
[4] XU Sainan,YANG Lei . Apoptosis of epithelial cells in nasal polyps promoted by erythromycin[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 27 -29 .
[5] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 94 -95 .
[6] LIU Lian-he . Treatment of deep neck abscess in 37 cases[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(2): 180 -181 .
[7] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 200 -203 .
[8] QIAO Yi,NI Guan-sen,CHEN Wen-wen . Effect of H-UPPP and nasal operations on obstructive sleep apnea syndrome in 38 cases
[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 206 -208 .
[9] WANG Xiao-feng,LIN Chang,CHENG Jin-mei . Expression of ABAD in inner ears and its clinical significance in different age mice[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 207 -211 .
[10] FAN Qi-jun,HUANG Zhi-wu,MEI Ling,XIAO Bo-kui . Expression of the heat shock protein 27 in rat cochlea induced by sodium salicylate injection by the FQ-PCR technique[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 212 -214 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd