BACKGROUND: The optimal surgical treatment in children with well-differentiated thyroid carcinoma remains an important point of discussion. In this study, we evaluated our surgical experience and reviewed the literature accordingly to identify the most adequate treatment. METHODS: We retrospectively analyzed 21 children, all under the age of 18 years at the time of diagnosis, with differentiated thyroid carcinoma (17 papillary, 3 follicular, and 1 Hürthle cell carcinoma). Total thyroidectomy was performed, followed by radioiodine therapy, as a part of the initial treatment in all patients. The results were compared with data from the literature. RESULTS: Eleven children (52%) who presented with cervical lymph node metastases were treated by a modified radical neck dissection. Pulmonary metastases were seen at diagnosis in three patients. Six patients developed temporary complications. During follow-up, with a median of 11 years (range, 2-26 years), two patients (10%) developed recurrences, and no patient died during this observation period. A literature search confirmed our experience of excellent results without an increase of complications in the more aggressively treated patients. CONCLUSIONS: In children with differentiated thyroid cancer, treatment should consist of total thyroidectomy, followed by a modified radical neck dissection (when indicated) and iodine-131 ablation treatment. This aggressive approach seems to be justified because of the high incidence of nodal involvement and the low complication and recurrence rate after surgery.
BACKGROUND: The optimal surgical treatment in children with well-differentiated thyroid carcinoma remains an important point of discussion. In this study, we evaluated our surgical experience and reviewed the literature accordingly to identify the most adequate treatment. METHODS: We retrospectively analyzed 21 children, all under the age of 18 years at the time of diagnosis, with differentiated thyroid carcinoma (17 papillary, 3 follicular, and 1 Hürthle cell carcinoma). Total thyroidectomy was performed, followed by radioiodine therapy, as a part of the initial treatment in all patients. The results were compared with data from the literature. RESULTS: Eleven children (52%) who presented with cervical lymph node metastases were treated by a modified radical neck dissection. Pulmonary metastases were seen at diagnosis in three patients. Six patients developed temporary complications. During follow-up, with a median of 11 years (range, 2-26 years), two patients (10%) developed recurrences, and no patient died during this observation period. A literature search confirmed our experience of excellent results without an increase of complications in the more aggressively treated patients. CONCLUSIONS: In children with differentiated thyroid cancer, treatment should consist of total thyroidectomy, followed by a modified radical neck dissection (when indicated) and iodine-131 ablation treatment. This aggressive approach seems to be justified because of the high incidence of nodal involvement and the low complication and recurrence rate after surgery.
Authors: Scott A Rivkees; Ernest L Mazzaferri; Frederik A Verburg; Christoph Reiners; Markus Luster; Christopher K Breuer; Catherine A Dinauer; Robert Udelsman Journal: Endocr Rev Date: 2011-08-31 Impact factor: 19.871
Authors: Ian D Hay; Tomas Gonzalez-Losada; Megan S Reinalda; Jennifer A Honetschlager; Melanie L Richards; Geoffrey B Thompson Journal: World J Surg Date: 2010-06 Impact factor: 3.352
Authors: Yuri E Demidchik; Eugene P Demidchik; Christoph Reiners; Johannes Biko; Mariko Mine; Vladimir A Saenko; Shunichi Yamashita Journal: Ann Surg Date: 2006-04 Impact factor: 12.969
Authors: Giovanni Federico; Giuseppe Boni; Barbara Fabiani; Lisa Fiore; Patrizia Lazzeri; Francesco Massart; Claudio Traino; Carmela Verola; Giuseppe Saggese; Giuliano Mariani; Roberto Scarpato Journal: Eur J Nucl Med Mol Imaging Date: 2008-07-22 Impact factor: 9.236