ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume: 15 Issue: 2 Year: 2023
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Turkish Society for Pediatric Endocrinology and Diabetes
Differentiated Thyroid Cancer in Adolescents: Single Center Experience and Considerations for Surgical Management and Radioiodine Treatment [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. Ahead of Print: JCRPE-94840 | DOI: 10.4274/jcrpe.galenos.2023.2023-1-16

Differentiated Thyroid Cancer in Adolescents: Single Center Experience and Considerations for Surgical Management and Radioiodine Treatment

Costanza Chiapponi1, Milan Janis Michael Hartmann1, Boris Decarolis2, Thorsten Simon2, Christiane Josephine Bruns1, Michael Faust3, Anne Maria Schultheis4, Matthias Schmidt5, Hakan Alakus1
1Department of General, Visceral, Cancer and Transplant Surgery, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
2Department of Pediatric Oncology, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
3Polyclinic for Endocrinology, Diabetes and Preventive Medicine, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
4Department of Pathology, University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany
5Department of Nuclear Medicine, Faculty of Medicine, University Hospital Cologne and University Hospital Cologne, Kerpener Str. 62, 50937 Cologne, Germany

INTRODUCTION: Background: Differentiated thyroid cancer (DTC) in adolescents is a rare disease with favorable outcome, despite higher rates of cervical lymph node and pulmonary metastasis compared to adults. Aim of this study was to critically evaluate its treatment.
METHODS: Methods: Patients receiving postoperative radiojodine treatment (RAIT) for DTC between 2005 and 2020 at our institution were screened to identify adolescents according to the WHO definition (10-19 years of age). Demographics, clinico-pathologic characteristics, treatment and outcome were analyzed.
RESULTS: Results: Among 1897 DTC patients 23 (1.3%) were adolescents (median age 16 years, range 10-18). The female to male ratio was 3.6: 1. Classic papillary thyroid cancer was seen in 60%, follicular variant in 40% of cases, which is higher than reported in the literature (15-25%) for this age group. pT-status was pT1 in 9 (39.2%), pT2 in 8 (34.8%), pT3 in 3 (13%) and pT4 status in 3(13%) patients. In 19 (82.6%) patients, central lymphadenectomy was performed revealing metastasis in 57%. All patients received RAIT with an initial activity of 1.2 (n=1, 4.3%), 2 (n=12, 52.2%) or 3.7 GBq (n=10, 43.5%). Eighteen (78.2%) patients are free of biochemical and radiologic disease in a median follow-up of 60.7 months. Second-line surgery of lymph nodal relapse was necessary in 3 (13%) cases. There was one diseaseassociated death.
DISCUSSION AND CONCLUSION: Conclusion: Despite high rates of metastasis, most patients were cured, and second-line surgery was rarely required. Further prospective studies are needed to determine whether less aggressive surgical management or omitting adjuvant RAIT are feasible in limited stages.

Keywords: differentiated thyroid cancer, adolescents, prophylactic lymphadenectomy



Corresponding Author: Costanza Chiapponi, Germany
Manuscript Language: English
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