Document Detail


Prognosis and risk stratification in young papillary thyroid carcinoma patients.
MedLine Citation:
PMID:  18469487     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Controversies remain regarding to the therapeutic methods of papillary thyroid cancer (PTC) in young patients. TNM staging and other risk evaluation system are not perfectly applicable for all young PTC patients in view of disease outcome. The aims of this study are to identify the clinical presentations, prognostic factors and risk analysis methods. From January, 1977, to June, 2006, seventy-seven patients with primary PTC younger than 20 years old at Chang Gung Medical Center in Taiwan were enrolled in this retrospective study. The patients were classified as disease-free or non-disease-free according to presence or absence of distant metastases or local recurrence at the end of follow-up. Clinical data of these patients were analyzed and compared. The average follow-up period was 10.3 years. Two patients died of PTC during the follow-up period; one died of brain metastasis, and one died of airway obstruction. Patients undergoing total thyroidectomy, especially those with disease beyond the thyroid, had better outcomes than patients not undergoing total thyroidectomy (p = 0.003). Moreover, the DeGroot clinical classification system was a better predictor of prognosis than TNM (p<0.001 vs p = 0.007). Our results suggest that prognosis for PTC is not worse in younger patients. However, patients who had undergone total thyroidectomy might have a better prognosis. Clinical classification is a good alternative classification system for predicting disease outcome in young PTC patients. Patients with confined intrathyroid lesion (<or=T2, N0, M0) may be regarded "low risk" PTC patients.
Authors:
Sheng-Fong Kuo; Tzu-Chieh Chao; Chuen Hsueh; Wen-Yu Chuang; Chung-Han Yang; Jen-Der Lin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Endocrine journal     Volume:  55     ISSN:  1348-4540     ISO Abbreviation:  Endocr. J.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-05-12     Completed Date:  2008-08-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9313485     Medline TA:  Endocr J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  269-75     Citation Subset:  IM    
Affiliation:
Division of Endocrinology and Metabolism, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Carcinoma, Papillary / diagnosis*,  epidemiology*,  pathology,  surgery
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Kaplan-Meiers Estimate
Male
Neoplasm Metastasis
Neoplasm Recurrence, Local / epidemiology
Neoplasm Staging
Prognosis
Retrospective Studies
Risk Assessment
Taiwan / epidemiology
Thyroid Neoplasms / diagnosis*,  epidemiology*,  surgery
Thyroidectomy

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