Primary presentation and clinical course of pediatric and adolescent patients with differentiated thyroid carcinoma after radioiodine therapy

Frontiers in Oncology

Oncology

Isabell Pekrul¹  Arnold Trupka²  Julia Hornung³  Peter Bartenstein³  Vera Wenter³  Caroline Burgard⁴  Freba Grawe⁵  Mathias Johannes Zacherl⁶  Andrei Todica⁶  Johanna Wagner⁷  Detlef Krenz⁸  Roland Ladurner⁹  Christine Spitzweg^1,10  Christine Schmid-Tannwald^1,11  Petra Zimmermann^1,12 

[1] Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany;Department of Endocrine Surgery, Starnberg Hospital, Starnberg, Germany;Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany;Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany;Department of Nuclear Medicine, Saarland University, UdS, Homburg, Germany;Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany;Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany;Department of Nuclear Medicine, LMU University Hospital, LMU Munich, Munich, Germany;Interdisciplinary Center for Thyroid Carcinoma (ISKUM), LMU University Hospital, LMU Munich, Munich, Germany;Department of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Dr. von Hauner Children’s Hospital, LMU University Hospital, LMU Munich, Munich, Germany;Department of Surgery, Klinikum Dritter Orden, Munich, Germany;Department of Surgery, Martha-Maria Krankenhaus, Munich, Germany;Interdisciplinary Center for Thyroid Carcinoma (ISKUM), LMU University Hospital, LMU Munich, Munich, Germany;Department of Internal Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany;Interdisciplinary Center for Thyroid Carcinoma (ISKUM), LMU University Hospital, LMU Munich, Munich, Germany;Department of Radiology, LMU University Hospital, LMU Munich, Munich, Germany;Interdisciplinary Center for Thyroid Carcinoma (ISKUM), LMU University Hospital, LMU Munich, Munich, Germany;Department of Visceral and Endocrinological Surgery, LMU University Hospital, LMU Munich, Munich, Germany;

关键词: thyroid carcinoma;    radioiodine therapy;    pediatric oncology;    children;    adolescents;    patient outcome;   

DOI  :  10.3389/fonc.2023.1237472

 received in 2023-06-09, accepted in 2023-09-05,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionDifferentiated thyroid carcinoma (DTC) in childhood and during adolescence is extremely rare. Pediatric DTC commonly presents with advanced disease at diagnosis including a high prevalence of cervical lymph node metastases and pulmonary metastases. Studies in children with DTC are limited. Therefore, we aimed to evaluate the initial presentation, effectiveness of radioiodine therapy (RIT), and long-term outcome of prepubertal in comparison to pubertal/postpubertal patients.MethodsEighty-five pediatric and young patients aged 6.4 to 21.9 years with histopathologically confirmed DTC were retrospectively included. They all underwent total thyroidectomy followed by RIT. Initial presentation and outcome of prepubertal and pubertal/postpubertal patients were compared 1 year after RIT, during follow-up, and at the last visit of follow-up.ResultsPrepubertal patients presented with significantly higher T and M stages. One year after RIT, 42/81 (52%) patients still presented with evidence of disease (ED). During follow-up of a median of 7.9 years, prepubertal patients were less often in complete remission (58% vs. 82% in pubertal patients). At the last visit of follow-up, 19/80 (24%) patients still had ED without statistical differences between the two groups (42% prepubertal vs. 18% pubertal/postpubertal, p-value 0.06). None of our patients died disease-related over the observed period.ConclusionPrepubertal children with DTC presented with a more advanced tumor stage at the initial presentation. During follow-up, they present more often with ED. However, at the end of our study, we did not observe statistically relevant differences in patient outcomes between the prepubertal and pubertal/postpubertal groups.

【 授权许可】

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Copyright © 2023 Burgard, Zacherl, Todica, Hornung, Grawe, Pekrul, Zimmermann, Schmid-Tannwald, Ladurner, Krenz, Trupka, Wagner, Bartenstein, Spitzweg and Wenter