Korean J Endocr Surg.  2010 Mar;10(1):34-38. 10.16956/kjes.2010.10.1.34.

Fifteen Years or Greater Follow-Up of Pediatric Differentiated Thyroid Cancer

• Kim AR
• Sung CW
• Park YS
• Kim CS
• Kim KT

• KMID: 2375731
• DOI: http://doi.org/10.16956/kjes.2010.10.1.34

Abstract

PURPOSE
Thyroid cancer is rare in childhood. Although thyroid cancer is biologically more aggressive in children because of the high incidence of lymph node metastasis and distant metastasis when compared with that of adults, the prognosis is better. This study investigated the prognosis of pediatric differentiated thyroid cancer with 15 years or greater follow-up and we consider the proper treatment of pediatric differentiated thyroid cancer.
METHODS
From January, 1979 to December, 1994 during 16 years, 17 patients younger than 17 years old and who underwent thyroid surgery for well differentiated thyroid cancer at the Department of Surgery at Presbyterian Medical Center were retrospectively reviewed by the medical records and they were interviewed by telephone.
RESULTS
Total thyroidectomy was performed in 4 patients (23.5%), subtotal thyroidectomy was performed in 10 patients (58.8%) and lobectomy was performed in 3 patients (17.7%). The mean follow-up period was 23.5 years (range: 15~28.2 years) and recurrence was found in 7 cases (41.3%). Five cases (29.5%) showed locoregional recurrence and 2 cases (11.8%) showed distant metastasis. Postoperative radioiodine (¹³¹I) therapy was done in 6 cases (35%) and 6 cases (35%) underwent radioiodine therapy as a therapeutic modality for metastasis.
CONCLUSION
The pediatric well differentiated thyroid cancer in this study showed high rates of lymph node metastasis at the time of diagnosis and a high recurrence rate, but the prognosis was good (100% overall survival rate during the follow-up period). Therefore, total thyroidectomy, radical lymph node dissection and postoperative radioiodine therapy are considered the initial patient management. This aggressive therapeutic management can decrease of the recurrence rate and increase the therapeutic effect. A radioiodine scan and thyroglobulin can used for follow-up.

Keyword

Pediatric differentiated thyroid cancer; Total thyroidectomy and radical lymph node dissection; Radioiodine therapy

MeSH Terms

Adult
Child
Diagnosis
Follow-Up Studies*
Humans
Incidence
Lymph Node Excision
Lymph Nodes
Medical Records
Neoplasm Metastasis
Prognosis
Protestantism
Recurrence
Retrospective Studies
Survival Rate
Telephone
Thyroglobulin
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy
Thyroglobulin

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