Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 22:10:914942.
doi: 10.3389/fped.2022.914942. eCollection 2022.

Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors

Cristina Martucci  1 , Alessandro Crocoli  1 , Maria Debora De Pasquale  2 , Claudio Spinelli  3 , Silvia Strambi  3 , Paolo Brazzarola  4 , Eleonora Morelli  4 , Jessica Cassiani  5 , Juliana Mancera  6 , Juan Pablo Luengas  7 , Pablo Lobos  8 , Daniel Liberto  8 , Estefanìa Astori  8 , Sabine Sarnacki  9 , Vincent Couloigner  10 , François Simon  10 , Cassandre Lambert  10 , Simone de Campos Vieira Abib  11 , Onivaldo Cervantes  12 , Eliana Caran  11 , Diana Delgado Lindman  11 , Matthew O Jones  13 , Rajeev Shukla  14 , Paul D Losty  15 , Alessandro Inserra  1
Affiliations

Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors

Cristina Martucci et al. Front Pediatr. .

Abstract

Background: Thyroid gland malignancies are rare in pediatric patients (0.7% of tumors); only 1.8% are observed in patients aged <20 years, with a higher prevalence recorded in women and adolescents. Risk factors include genetic syndromes, MEN disorders, autoimmune diseases, and exposure to ionizing radiation. Radiotherapy is also associated with an increased risk of secondary thyroid cancer. This study describes the clinical features and surgical outcomes of primary and secondary thyroid tumors in pediatric patients.

Methods: Institutional data were collected from eight international surgical oncology centers for pediatric patients with thyroid cancer between 2000 and 2020. Statistical analyses were performed using the GraphPad Prism software.

Results: Among 255 total cases of thyroid cancer, only 13 (5.1%) were secondary tumors. Primary thyroid malignancies were more likely to be multifocal in origin (odds ratio [OR] 1.993, 95% confidence interval [CI].7466-5.132, p = 0.2323), have bilateral glandular location (OR 2.847, 95% CI.6835-12.68, p = 0.2648), and be metastatic at first diagnosis (OR 1.259, 95% CI.3267-5.696, p > 0.999). Secondary tumors showed a higher incidence of disease relapse (OR 1.556, 95% CI.4579-5.57, p = 0.4525) and surgical complications (OR 2.042, 95% CI 0.7917-5.221, p = 0.1614), including hypoparathyroidism and recurrent laryngeal nerve injury. The overall survival (OS) was 99% at 1 year and 97% after 10 years. No EFS differences were evident between the primary and secondary tumors (chi-square 0.7307, p = 0.39026).

Conclusions: This multicenter study demonstrated excellent survival in pediatric thyroid malignancies. Secondary tumors exhibited greater disease relapse (15.8 vs. 10.5%) and a higher incidence of surgical complications (36.8 vs. 22.2%).

Keywords: cancer; carcinoma; children; surgery; thyroid.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Overall survival (OS) of the study population.
Figure 2
Figure 2
Event free survival (EFS) for primary and secondary thyroid neoplasms.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chan CM, Prager J, Travers S. Pediatric Thyroid Cancer. Adv Pediatr. (2017) 64:171–90. 10.1016/j.yapd.2017.03.007 - DOI - PubMed
    1. Hogan AR, Zhuge Y, Perez EA, Koniaris LG, Lew JI, Sola JE. Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients. J Surg Res. (2009) 156:167–72. 10.1016/j.jss.2009.03.098 - DOI - PubMed
    1. Morris LG, Sikora AG, Myssiorek D, DeLacure MD. The basis of racial differences in the incidence of thyroid cancer. Ann Surg Oncol. (2008) 15:1169–76. 10.1245/s10434-008-9812-6 - DOI - PubMed
    1. Francis GL, Waguespack SG, Bauer AJ, Angelos P, Benvenga S, Cerutti JM, et al. . Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. (2015) 25:716–59. 10.1089/thy.2014.0460 - DOI - PMC - PubMed
    1. Bertherat J, Horvath A, Groussin L, Grabar S, Boikos S, Cazabat L, et al. . Mutations in regulatory subunit type 1A of cyclic adenosine 5'-monophosphate-dependent protein kinase (PRKAR1A): phenotype analysis in 353 patients and 80 different genotypes. J Clin Endocrinol Metab. (2009) 94:2085–91. 10.1210/jc.2008-2333 - DOI - PMC - PubMed

LinkOut - more resources