Clinical Features, Risk Classifications and Long-Term Follow Up Of Childhood Differentiated Thyroid Cancer (DTC): A Single Reference-Center Experience

Kızılcan Çetin S., Aycan Z., Şıklar Z., Özsu E., Fitoz Ö. S., Berberoğlu M.

The 60th Annual ESPE Meeting , Rome, Italy, 15 - 19 September 2022, pp.414

  • Publication Type: Conference Paper / Summary Text
  • City: Rome
  • Country: Italy
  • Page Numbers: pp.414
  • Ankara University Affiliated: Yes

Abstract

Background:Thyroid cancers are rare in childhood.Pediatric ATA guideline has been applied in daily practice since 2015.It is very significant to accurately predict the risk in the management of differentiated thyroid cancer(DTC).For this purpose, we shared our single center-20-year-experience about the follow-up features and management of childhood and adolescent thyroid cancer.We aimed to evaluate the dynamic risk stratification (DRS) and the other prognostic factors of DTC in childhood.

Methods: This retrospective study identified 41cases with DTC(F/M:35/6)followed for a median of an estimated five years(range:1–15 years)after total thyroidectomy.We classified patients according to the response to treatment and the course of the disease,according to both the 2015 pediatric ATA guideline and DRS,which was used for adults.Pretreatment risks,clinical features,treatment,and follow-up characteristics were retrieved.DTC status was evaluated after the initial therapy and at the last follow-up visit(Table 1).

Results:41patients aged 5.9–19.6years were evaluated.25 had history of thyroid disease(4congenital thyroid disease,17chronic lymphocytic thyroidit,1graves disease,3multinodular goiter).33 had papillary thyroid carcinomas.Tumor size was 1.2cm(0.4-5),mostly localizated on right lobe.27 had cervical and one had distant metastasis at diagnosis. All patients underwent total thyroidectomy,16 had radioactive iodine treatment(30-200mCi). LN dissection(LND) was performed in 68% (29.3%central±lateral,14.6%berry picking).One patient needed residual tumor excision.Risk factors were classified according to ATA 2015 and DRS classification(Table 1). 35 had in low risk according to ATA guideline,however they were classified as excellent response(n =32 ),indeterminate response(n = 4),biochemical incomplete response(n =4 ),structural incomplete response(n = 1) according to DRS.

Conclusion:Our study supported that the 2015 ATA staging system was adequate for follow-up.In addition,DRS risk estimates contribute significantly to baseline and post-treatment follow-up.