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Comparison of differentiated thyroid cancer in children and adolescents (≤20 years) with young adults
Author(s) -
Alzahrani Ali S.,
Alkhafaji Dania,
Tuli Mahmoud,
AlHindi Hindi,
Sadiq Bakr Bin
Publication year - 2016
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.12845
Subject(s) - medicine , thyroid cancer , pathological , context (archaeology) , young adult , lymph node , thyroid , age groups , pediatrics , gastroenterology , demography , sociology , paleontology , biology
Summary Context Age is a major prognostic factor in differentiated thyroid cancer ( DTC ). It is not clear if paediatric DTC has a different histopathological profile and outcome than DTC in adult patients <45 years of age. Objective To assess whether DTC in children and adolescents differs from young age group by comparing paediatric DTC (age ≤ 20) with DTC in patients >20 to <45 years of age. Patients and methods We studied all cases of paediatric DTC seen during the period 1998–2011. We compared this group with a large sample of 213 consecutive adult patients in the age group >20 to <45 years seen during the period 1998–1999 in terms of their pathological features, extent of the disease and long‐term outcome. Both groups were managed by the same team at a single institution. Results A total of 310 DTC were studied including 97 paediatric patients [median age 17 years (range, 8–20)] and 213 young adult patients [median age 33 years (range, 20·5–44·9)]. There was no difference in gender distribution, tumour subtypes, size and tumour multifocality, but there was a significantly higher rate of extrathyroidal extension [40/75 (53·3%) vs 81/213 (38·0%), P = 0·03], lymph node [57/73 (78%) vs 102/183 (55·7%), P < 0·0001] and distant metastases [16/97 (16·5%) vs 8/213 (3·8%), P < 0·0001] in the paediatric than the adult groups. Kaplan–Meier analysis showed a higher risk of persistent/recurrent disease in the paediatric group than adults (log‐rank test 0·03). However, there was no mortality secondary to DTC in both groups. Conclusion Paediatric DTC is distinct from DTC in the young adults (age >20 to <45 years). It is characterized by a higher rate of extrathyroidal extension, lymph node and distant metastases and a higher risk of persistent/recurrent DTC .