Differentiated Thyroid Cancer in Children and Adolescents: Long Term Outcome and Risk Factors for Persistent Disease
Background: Pediatric differentiated thyroid cancer (P-DTC) frequently presents with advanced disease. The study aim was to evaluate the outcome of P-DTC and a modified 2015 American Thyroid Association risk classification (ATA-R). Methods: A retrospective study of consecutive P-DTC patients was per...
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| Veröffentlicht in: | Cancers 2021-07, Vol.13 (15), p.3732 |
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| creator | Sapuppo, Giulia Hartl, Dana Fresneau, Brice Hadoux, Julien Breuskin, Ingrid Baudin, Eric Rigaud, Charlotte Guerlain, Joanne Al Ghuzlan, Abir Leboulleux, Sophie Schlumberger, Martin Lamartina, Livia |
| description | Background: Pediatric differentiated thyroid cancer (P-DTC) frequently presents with advanced disease. The study aim was to evaluate the outcome of P-DTC and a modified 2015 American Thyroid Association risk classification (ATA-R). Methods: A retrospective study of consecutive P-DTC patients was performed. The ATA-R for P-DTC was used with a cut-off of ≤ 5 N1a for low-risk. The outcome could be excellent response (ER) (thyroglobulin < 1 ng/mL and no evidence of disease (EoD) at imaging), biochemical incomplete response (BIR) (thyroglobulin ≥ 1 ng/mL and no EoD at imaging) or structural incomplete response (SIR) (EoD at imaging). Results: We studied 260 P-DTC (70% females; median age at diagnosis 14 years; 93% total thyroidectomy and 82% lymph node dissection). The ATA-R was low in 30% cases, intermediate in 15% and high in 55%, including 31.5% with distant metastases. Radioiodine treatment was administered in 218 (83.8%), and further radioiodine and surgery was performed in 113 (52%) and 76 (29%) patients, respectively. After a median follow-up of 8.2 years, the outcome was ER in 193 (74.3%), BIR in 17 (6.5%) and SIR in 50 (19.2%). Independent predictors of SIR or BIR at first and last visits were ATA-R intermediate or high. Conclusion: P-DTC has an excellent prognosis. Modified ATA-R is a useful prognostic tool in P-DTC to guide management. |
| doi_str_mv | 10.3390/cancers13153732 |
| format | Article |
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The study aim was to evaluate the outcome of P-DTC and a modified 2015 American Thyroid Association risk classification (ATA-R). Methods: A retrospective study of consecutive P-DTC patients was performed. The ATA-R for P-DTC was used with a cut-off of ≤ 5 N1a for low-risk. The outcome could be excellent response (ER) (thyroglobulin < 1 ng/mL and no evidence of disease (EoD) at imaging), biochemical incomplete response (BIR) (thyroglobulin ≥ 1 ng/mL and no EoD at imaging) or structural incomplete response (SIR) (EoD at imaging). Results: We studied 260 P-DTC (70% females; median age at diagnosis 14 years; 93% total thyroidectomy and 82% lymph node dissection). The ATA-R was low in 30% cases, intermediate in 15% and high in 55%, including 31.5% with distant metastases. Radioiodine treatment was administered in 218 (83.8%), and further radioiodine and surgery was performed in 113 (52%) and 76 (29%) patients, respectively. After a median follow-up of 8.2 years, the outcome was ER in 193 (74.3%), BIR in 17 (6.5%) and SIR in 50 (19.2%). Independent predictors of SIR or BIR at first and last visits were ATA-R intermediate or high. Conclusion: P-DTC has an excellent prognosis. Modified ATA-R is a useful prognostic tool in P-DTC to guide management.</description><identifier>ISSN: 2072-6694</identifier><identifier>EISSN: 2072-6694</identifier><identifier>DOI: 10.3390/cancers13153732</identifier><identifier>PMID: 34359632</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Cancer therapies ; Classification ; Digital archives ; Dissection ; Iodine ; Lymph nodes ; Lymphatic system ; Medical prognosis ; Metastases ; Metastasis ; Patients ; Pediatrics ; Prognosis ; Remission (Medicine) ; Risk factors ; Surgery ; Teenagers ; Thyroglobulin ; Thyroid cancer ; Thyroidectomy ; Tumors</subject><ispartof>Cancers, 2021-07, Vol.13 (15), p.3732</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 by the authors. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c398t-21f9034195b9be7ac06dab7ea5cd59c3fae66d75204d9ce2af450b325d3889233</citedby><cites>FETCH-LOGICAL-c398t-21f9034195b9be7ac06dab7ea5cd59c3fae66d75204d9ce2af450b325d3889233</cites><orcidid>0000-0002-8471-7310 ; 0000-0001-7603-7828 ; 0000-0001-5198-6111</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345030/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345030/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53770,53772</link.rule.ids></links><search><creatorcontrib>Sapuppo, Giulia</creatorcontrib><creatorcontrib>Hartl, Dana</creatorcontrib><creatorcontrib>Fresneau, Brice</creatorcontrib><creatorcontrib>Hadoux, Julien</creatorcontrib><creatorcontrib>Breuskin, Ingrid</creatorcontrib><creatorcontrib>Baudin, Eric</creatorcontrib><creatorcontrib>Rigaud, Charlotte</creatorcontrib><creatorcontrib>Guerlain, Joanne</creatorcontrib><creatorcontrib>Al Ghuzlan, Abir</creatorcontrib><creatorcontrib>Leboulleux, Sophie</creatorcontrib><creatorcontrib>Schlumberger, Martin</creatorcontrib><creatorcontrib>Lamartina, Livia</creatorcontrib><title>Differentiated Thyroid Cancer in Children and Adolescents: Long Term Outcome and Risk Factors for Persistent Disease</title><title>Cancers</title><description>Background: Pediatric differentiated thyroid cancer (P-DTC) frequently presents with advanced disease. The study aim was to evaluate the outcome of P-DTC and a modified 2015 American Thyroid Association risk classification (ATA-R). Methods: A retrospective study of consecutive P-DTC patients was performed. The ATA-R for P-DTC was used with a cut-off of ≤ 5 N1a for low-risk. The outcome could be excellent response (ER) (thyroglobulin < 1 ng/mL and no evidence of disease (EoD) at imaging), biochemical incomplete response (BIR) (thyroglobulin ≥ 1 ng/mL and no EoD at imaging) or structural incomplete response (SIR) (EoD at imaging). Results: We studied 260 P-DTC (70% females; median age at diagnosis 14 years; 93% total thyroidectomy and 82% lymph node dissection). The ATA-R was low in 30% cases, intermediate in 15% and high in 55%, including 31.5% with distant metastases. Radioiodine treatment was administered in 218 (83.8%), and further radioiodine and surgery was performed in 113 (52%) and 76 (29%) patients, respectively. After a median follow-up of 8.2 years, the outcome was ER in 193 (74.3%), BIR in 17 (6.5%) and SIR in 50 (19.2%). Independent predictors of SIR or BIR at first and last visits were ATA-R intermediate or high. Conclusion: P-DTC has an excellent prognosis. Modified ATA-R is a useful prognostic tool in P-DTC to guide management.</description><subject>Cancer therapies</subject><subject>Classification</subject><subject>Digital archives</subject><subject>Dissection</subject><subject>Iodine</subject><subject>Lymph nodes</subject><subject>Lymphatic system</subject><subject>Medical prognosis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Prognosis</subject><subject>Remission (Medicine)</subject><subject>Risk factors</subject><subject>Surgery</subject><subject>Teenagers</subject><subject>Thyroglobulin</subject><subject>Thyroid cancer</subject><subject>Thyroidectomy</subject><subject>Tumors</subject><issn>2072-6694</issn><issn>2072-6694</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpdkc9L7DAQx4M8UVHPXgPv4mU1yTRt8w6CrD9hQZH1HNJk6kbbxpe0gv-9WRVRc5nAfObDdxhCDjg7AlDs2JrBYkwcuIQKxAbZEawSs7JUxZ9v_22yn9Ijyw-AV2W1RbahAKlKEDtkPPNtixGH0ZsRHV2uXmPwjs7f3dQPdL7yncsANYOjpy50mGzG0z-6CMMDXWLs6c002tDjO3Ln0xO9MHYMMdE2RHqbM_o05hl65hOahHtkszVdwv3PukvuL86X86vZ4ubyen66mFlQ9TgTvFUMCq5koxqsjGWlM02FRlonlYXWYFm6SgpWOGVRmLaQrAEhHdS1EgC75OTD-zw1Pbp17Gg6_Rx9b-KrDsbrn53Br_RDeNE1ZBOwLDj8FMTwf8I06t7n7bvODBimpIWUqhCKg8jo31_oY5jikNdbU3UlauBr4fEHZWNIKWL7FYYzvT6q_nVUeAOK-pX8</recordid><startdate>20210724</startdate><enddate>20210724</enddate><creator>Sapuppo, Giulia</creator><creator>Hartl, Dana</creator><creator>Fresneau, Brice</creator><creator>Hadoux, Julien</creator><creator>Breuskin, Ingrid</creator><creator>Baudin, Eric</creator><creator>Rigaud, Charlotte</creator><creator>Guerlain, Joanne</creator><creator>Al Ghuzlan, Abir</creator><creator>Leboulleux, Sophie</creator><creator>Schlumberger, Martin</creator><creator>Lamartina, Livia</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7TO</scope><scope>7XB</scope><scope>8FE</scope><scope>8FH</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M2O</scope><scope>M7P</scope><scope>MBDVC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-8471-7310</orcidid><orcidid>https://orcid.org/0000-0001-7603-7828</orcidid><orcidid>https://orcid.org/0000-0001-5198-6111</orcidid></search><sort><creationdate>20210724</creationdate><title>Differentiated Thyroid Cancer in Children and Adolescents: Long Term Outcome and Risk Factors for Persistent Disease</title><author>Sapuppo, Giulia ; 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The study aim was to evaluate the outcome of P-DTC and a modified 2015 American Thyroid Association risk classification (ATA-R). Methods: A retrospective study of consecutive P-DTC patients was performed. The ATA-R for P-DTC was used with a cut-off of ≤ 5 N1a for low-risk. The outcome could be excellent response (ER) (thyroglobulin < 1 ng/mL and no evidence of disease (EoD) at imaging), biochemical incomplete response (BIR) (thyroglobulin ≥ 1 ng/mL and no EoD at imaging) or structural incomplete response (SIR) (EoD at imaging). Results: We studied 260 P-DTC (70% females; median age at diagnosis 14 years; 93% total thyroidectomy and 82% lymph node dissection). The ATA-R was low in 30% cases, intermediate in 15% and high in 55%, including 31.5% with distant metastases. Radioiodine treatment was administered in 218 (83.8%), and further radioiodine and surgery was performed in 113 (52%) and 76 (29%) patients, respectively. After a median follow-up of 8.2 years, the outcome was ER in 193 (74.3%), BIR in 17 (6.5%) and SIR in 50 (19.2%). Independent predictors of SIR or BIR at first and last visits were ATA-R intermediate or high. Conclusion: P-DTC has an excellent prognosis. Modified ATA-R is a useful prognostic tool in P-DTC to guide management.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34359632</pmid><doi>10.3390/cancers13153732</doi><orcidid>https://orcid.org/0000-0002-8471-7310</orcidid><orcidid>https://orcid.org/0000-0001-7603-7828</orcidid><orcidid>https://orcid.org/0000-0001-5198-6111</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cancer therapies Classification Digital archives Dissection Iodine Lymph nodes Lymphatic system Medical prognosis Metastases Metastasis Patients Pediatrics Prognosis Remission (Medicine) Risk factors Surgery Teenagers Thyroglobulin Thyroid cancer Thyroidectomy Tumors |
| title | Differentiated Thyroid Cancer in Children and Adolescents: Long Term Outcome and Risk Factors for Persistent Disease |
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