Tumor size is an independent negative prognostic factor for event free survival in children with differentiated thyroid cancer.
children
differentiated thyroid carcinoma
distant metastasis
event-free survival
tumor size
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2022
2022
Historique:
received:
27
06
2022
accepted:
08
08
2022
entrez:
12
9
2022
pubmed:
13
9
2022
medline:
14
9
2022
Statut:
epublish
Résumé
The incidence of pediatric differentiated thyroid carcinoma (DTC) is increasing. Despite the advanced disease at presentation, the overall prognosis of DTC in children is excellent. The aim of this study is to investigate the risk stratifying factors for event free survival (EFS) of pediatric DTC from Middle Eastern ethnicity. Eighty-eight patients aged ≤18 years with diagnosis of primary DTC were retrospectively analyzed. Cox proportional hazards model were used to calculate Hazard Ratios (HR) and Kaplan-Meier analysis were conducted to investigate EFS. Eighty-eight (23 males and 65 females) pediatric DTCs who underwent surgery and radioactive iodine therapy had been reported (median age at diagnosis 15 years; range 5.9-17.9), with lymph node metastasis (LNM) noted in 70.5% and distant metastasis in 13.6%. Mean follow-up was 8.4 years. Ten-year overall survival rate was 98.4% while 10-year EFS was 79.2%. EFS was negatively impacted by the presence of LNM, distant metastasis and tumor size >4cm. American Thyroid Association risk stratification did not impact EFS in our cohort. Multivariate analysis revealed tumor size >4cm (HR = 5.34; 95% confidence interval (CI) = 1.36 - 20.22; p = 0.0177) and distant metastasis (HR = 8.73; 95% CI = 1.48 - 60.05; p = 0.0154) as independent negative prognostic factors for EFS. Primary tumor size and the presence of distant metastasis at diagnosis are the only independent prognostic risk factors for EFS in pediatric DTC in Middle Eastern ethnicity. Children with tumor size over 4cm had poor EFS, which may justify the need of more aggressive treatment and frequent follow-up.
Sections du résumé
Background
The incidence of pediatric differentiated thyroid carcinoma (DTC) is increasing. Despite the advanced disease at presentation, the overall prognosis of DTC in children is excellent. The aim of this study is to investigate the risk stratifying factors for event free survival (EFS) of pediatric DTC from Middle Eastern ethnicity.
Methods
Eighty-eight patients aged ≤18 years with diagnosis of primary DTC were retrospectively analyzed. Cox proportional hazards model were used to calculate Hazard Ratios (HR) and Kaplan-Meier analysis were conducted to investigate EFS.
Results
Eighty-eight (23 males and 65 females) pediatric DTCs who underwent surgery and radioactive iodine therapy had been reported (median age at diagnosis 15 years; range 5.9-17.9), with lymph node metastasis (LNM) noted in 70.5% and distant metastasis in 13.6%. Mean follow-up was 8.4 years. Ten-year overall survival rate was 98.4% while 10-year EFS was 79.2%. EFS was negatively impacted by the presence of LNM, distant metastasis and tumor size >4cm. American Thyroid Association risk stratification did not impact EFS in our cohort. Multivariate analysis revealed tumor size >4cm (HR = 5.34; 95% confidence interval (CI) = 1.36 - 20.22; p = 0.0177) and distant metastasis (HR = 8.73; 95% CI = 1.48 - 60.05; p = 0.0154) as independent negative prognostic factors for EFS.
Conclusions
Primary tumor size and the presence of distant metastasis at diagnosis are the only independent prognostic risk factors for EFS in pediatric DTC in Middle Eastern ethnicity. Children with tumor size over 4cm had poor EFS, which may justify the need of more aggressive treatment and frequent follow-up.
Identifiants
pubmed: 36093088
doi: 10.3389/fendo.2022.979054
pmc: PMC9452778
doi:
Substances chimiques
Iodine Radioisotopes
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
979054Informations de copyright
Copyright © 2022 Parvathareddy, Siraj, Annaiyappanaidu, Siraj, Haqawi, Al-Sobhi, Al-Dayel and Al-Kuraya.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Références
Thyroid. 2010 Oct;20(10):1095-101
pubmed: 20860418
Pediatrics. 2014 Oct;134(4):e945-55
pubmed: 25201796
Thyroid. 2010 Dec;20(12):1341-9
pubmed: 21034228
Endocr Pract. 2008 Sep;14(6):764-74
pubmed: 18996800
Eur J Nucl Med Mol Imaging. 2022 Mar;49(4):1374-1385
pubmed: 34664092
Eur Thyroid J. 2015 Dec;4(4):252-9
pubmed: 26835429
Arch Pathol Lab Med. 2016 Feb;140(2):134-9
pubmed: 26910217
Thyroid. 2020 Dec;30(12):1771-1780
pubmed: 32495721
Front Endocrinol (Lausanne). 2019 Aug 07;10:552
pubmed: 31456750
J Pediatr. 2009 May;154(5):708-14
pubmed: 19167722
J Surg Res. 2009 Sep;156(1):167-72
pubmed: 19631341
Eur J Endocrinol. 2020 Oct;183(4):P11-P18
pubmed: 32698145
Eur J Nucl Med. 2000 Jul;27(7):833-41
pubmed: 10952495
J Clin Med. 2020 Nov 10;9(11):
pubmed: 33182677
Eur J Cancer. 2000 Jan;36(2):214-20
pubmed: 10741280
Int J Cancer. 2018 May 15;142(10):2028-2039
pubmed: 29266240
Thyroid. 2015 Jul;25(7):716-59
pubmed: 25900731
World J Surg. 2012 Jun;36(6):1241-6
pubmed: 22411092
World J Nucl Med. 2019 Nov 06;19(1):28-35
pubmed: 32190019
Endocrine. 2020 Dec;70(3):566-574
pubmed: 32533509
Med Pediatr Oncol. 2000 Jul;35(1):41-6
pubmed: 10881006
J Clin Endocrinol Metab. 2016 May;101(5):2031-9
pubmed: 26963949
J Clin Endocrinol Metab. 2022 Jan 1;107(1):e165-e177
pubmed: 34415989
Cancers (Basel). 2021 Jul 24;13(15):
pubmed: 34359632
Thyroid. 2002 Aug;12(8):683-702
pubmed: 12225637
Cancers (Basel). 2021 Feb 01;13(3):
pubmed: 33535609
Cancers (Basel). 2020 Oct 27;12(11):
pubmed: 33120984
Genes (Basel). 2019 Sep 18;10(9):
pubmed: 31540418
Thyroid. 2010 Apr;20(4):375-80
pubmed: 20373982
J Nucl Med. 2014 May;55(5):710-7
pubmed: 24722527
Cancer. 2019 Jul 15;125(14):2497-2505
pubmed: 31012956
World J Surg. 2018 Feb;42(2):329-342
pubmed: 29030676
Thyroid. 2016 Feb;26(2):219-26
pubmed: 26854950
Thyroid. 2016 Jan;26(1):1-133
pubmed: 26462967
JAMA Otolaryngol Head Neck Surg. 2019 Jul 1;145(7):617-623
pubmed: 31120475