Document Detail

Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus.
MedLine Citation:
PMID:  16552205     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: A retrospective study was designed to evaluate the results of surgical treatment and follow-up data in thyroid cancer patients less than 15 years old at the time of surgery. SUMMARY BACKGROUND DATA: Pediatric thyroid carcinomas have a high rate of lymph nodal and distant metastases. Risk factors for recurrences and postoperative morbidity have not been assessed yet in a representative series. METHODS: The group included 740 pediatric patients with thyroid cancer. Total thyroidectomy was performed in 426 (57.6%), lobectomy in 248 (33.5%), subtotal thyroidectomy in 58 (7.8%) cases, and 8 patients (1.1%) underwent partial lobectomy. RESULTS: The mean follow-up period was 115.8 months (range, 1.5-236.4 months). Recurrence was diagnosed in 204 cases (27.6%), including 73 local relapses (9.9%), 90 distant metastases (12.2%), and a combination of local and distant recurrences in 41 (5.5%) patients. Multivariate statistical assessment revealed the following independent parameters significantly associated with the risk of recurrent nodal disease: a young age at diagnosis, multifocal carcinomas, N1 status, and lack of neck lymph node dissection. For lung metastases, the significant risk factors were female gender, young age at diagnosis, and presence of symptoms. The observed 5- and 10-year survival for the entire group was 99.5% and 98.8%, respectively. Postoperative hypoparathyroidism was significantly associated with multifocal tumors, central compartment removal, and ipsilateral dissection. CONCLUSIONS: Total thyroidectomy followed by radioiodine therapy is an optimal treatment strategy that makes it possible to achieve a cure in a vast majority of pediatric patients with differentiated thyroid carcinomas. Risk of recurrence is strongly associated with tumor stage, extent of surgery, the young patient's age, and presence of symptoms at diagnosis.
Yuri E Demidchik; Eugene P Demidchik; Christoph Reiners; Johannes Biko; Mariko Mine; Vladimir A Saenko; Shunichi Yamashita
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of surgery     Volume:  243     ISSN:  0003-4932     ISO Abbreviation:  Ann. Surg.     Publication Date:  2006 Apr 
Date Detail:
Created Date:  2006-03-22     Completed Date:  2006-05-25     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  525-32     Citation Subset:  AIM; IM    
Department for Oncology, Belarusian State Medical University, Minsk, Belarus.
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MeSH Terms
Child, Preschool
Hypoparathyroidism / epidemiology
Iodine Radioisotopes / therapeutic use
Logistic Models
Lung Neoplasms / surgery
Lymph Node Excision
Lymphatic Metastasis
Neoplasm Recurrence, Local / epidemiology
Postoperative Complications / epidemiology
Risk Factors
Thyroid Neoplasms / surgery*
Vocal Cord Paralysis / epidemiology
Reg. No./Substance:
0/Iodine Radioisotopes

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