Comparison of clinical outcomes in differentiated thyroid carcinoma between children and young adult patients

Abstract

Objective: The aim of the present study was to evaluate differences between children and young adult patients in presentation, clinical course, and outcome of well-differentiated thyroid carcinoma (DTC).

Methods: We retrospectively reviewed the medical records of 61 children and young adults (50 female and 11 male; aged <25 years) with DTC who were treated with radioiodine (RI) and followed up between June 2002 and May 2010. All patients had undergone total thyroidectomy with lymph node dissection if enlarged lymph nodes were present and had been referred for initial radioiodine ablation. Recurrence-free survival was evaluated with the Kaplan-Meier method.

Results: At diagnosis, extrathyroidal extension of DTC was more prevalent and mean tumor size was bigger in children than in young adults (P = 0.045 and P = 0.002, respectively). However, there was no significant difference between the 2 groups with regard to the presence of lymph node or distant metastases (P = 0.885 and P = 1.000, respectively). During follow-up, the recurrence in the thyroid bed or cervical lymph nodes occurred in 6 children (20.7%) and in 3 young adults (9.4%; P = 0.323). The recurrence-free survival rate was similar in children and in young adults (log-rank test, χ1 = 2.424, P = 0.120).

Conclusions: Our result shows that, although the presentation of DTC at the time of diagnosis was more aggressive in children, intensive management elicited a similar clinical outcome in children and in young adults.