Pediatric Differentiated Thyroid Carcinoma in The Netherlands: A Nationwide Follow-Up Study

Marielle S. Klein Hesselink, Marloes Nies, Gianni Bocca, Adrienne H. Brouwers, Johannes G. M. Burgerhof, Eveline W. C. M. van Dam, Bas Havekes, Marry M. van den Heuvel-Eibrink, Eleonora P. M. Corssmit, Leontien C. M. Kremer, Romana T. Netea-Maier, Heleen J. H. van der Pal, Robin P. Peeters, Kurt W. Schmid, Johannes W. A. Smit, Graham R. Williams, John T. M. Plukker, Cecile M. Ronckers, Hanneke M. van Santen, Wim J. E. TissingThera P. Links*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

24 Citations (Scopus)

Abstract

Introduction: Treatment for differentiated thyroid carcinoma (DTC) in pediatric patients is based mainly on evidence from adult series due to lack of data from pediatric cohorts. Our objective was to evaluate presentation, treatment-related complications, and long-term outcome in patients with pediatric DTC in The Netherlands.

Patients and Methods: In this nationwide study, presentation, complications, and outcome of patients with pediatric DTC (age at diagnosis

Results: We identified 170 patients. Overall survival was 99.4% after a median follow-up of 13.5 years (range 0.3-44.7 y). Extensive follow-up data were available for 105 patients (83.8% women), treated in 39 hospitals. Median age at diagnosis was 15.6 years (range 5.8-18.9 y). At initial diagnosis, 43.8% of the patients had cervical lymph node metastases; 13.3% had distant metastases. All patients underwent total thyroidectomy. Radioiodine was administered to 97.1%, with a median cumulative activity of 5.66 GBq (range 0.74-35.15 GBq). Life-long postoperative complications (permanent hypoparathyroidism and/or recurrent laryngeal nerve injury) were present in 32.4% of the patients. At last known follow-up, 8.6% of the patients had persistent disease and 7.6% experienced a recurrence. TSH suppression was not associated with recurrences (odds ratio 2.00, 95% confidence interval 0.78-5.17, P = .152).

Conclusions: Survival of pediatric DTC is excellent. Therefore, minimizing treatment-related morbidity takes major priority. Our study shows a frequent occurrence of life-long postoperative complications. Adverse effects may be reduced by the centralization of care, which is crucial for children with DTC.

Original languageEnglish
Pages (from-to)2031-2039
Number of pages9
JournalJournal of Clinical Endocrinology and Metabolism
Volume101
Issue number5
DOIs
Publication statusPublished - May-2016

Keywords

  • RADIOACTIVE IODINE
  • UNITED-STATES
  • CHILDREN
  • CANCER
  • ADOLESCENTS
  • EXPERIENCE
  • MANAGEMENT
  • CHILDHOOD
  • SURGERY
  • GUIDELINES

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