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

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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

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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
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