Accessible Requires Authentication Published by De Gruyter August 29, 2018

Treatment outcomes in pediatric differentiated thyroid carcinoma

Nisha Bhavani, Kingini Bhadran, Vasantha Nair, Usha V. Menon, Praveen V. Pavithran, Arun S. Menon, Nithya Abraham, Aswin Pankaj and Harish Kumar

Abstract

Background

Until the American Thyroid Association (ATA) guidelines on management of pediatric differentiated thyroid carcinoma (DTC) became available in 2015, all children with DTC were treated like adults. This study aims to investigate the outcome of pediatric DTC and factors predicting the response to therapy in pediatric DTC managed according to adult guidelines.

Methods

Clinical records of 41 children less than 18 years of age diagnosed with DTC followed from 2007 in a single center were reviewed. According to the new ATA classification for pediatric DTC, five had low-risk, 28 had intermediate-risk and eight had high-risk disease at presentation.

Results

There was no mortality or recurrence in this cohort of pediatric DTC patients and the cure rate was 46% during a mean follow-up of 44 months when they were managed according to adult guidelines. Neither the new ATA risk classification nor any clinicopathological character was identified which could predict the response to therapy. The new ATA guidelines would have avoided 27% of the radioiodine therapies given.

Conclusions

This study showed that DTC in children managed according to adult guidelines had a good cure rate. The new ATA guidelines on pediatric DTC might have drastically reduced the number of radioiodine therapies in the affected children. Long term prospective studies are needed to validate the benefits and risks of both these approaches.


Corresponding author: Dr. Nisha Bhavani, Professor, Professor, Department of Endocrinology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam 682041, Kerala, India, Phone: +91 9895972765, E-mail:

Acknowledgments

The authors thank members of the Amrita Thyroid Cancer Clinic and Department of Biostatistics, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India, for supporting this work.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2018-02-13
Accepted: 2018-07-13
Published Online: 2018-08-29
Published in Print: 2018-10-25

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