A National Perspective of the Risk, Presentation, and Outcomes of Pediatric Thyroid Cancer

Al‐Qurayshi, Zaid; Hauch, Adam; Srivastav, Sudesh; Aslam, Rizwan; Friedlander, Paul; Kandil, Emad

doi:10.1001/jamaoto.2016.0104

Cited by 63 publications

(43 citation statements)

References 22 publications

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“…2). Compared to adults, PTC in pediatric and adolescents presents more lymph node metastases, distant metastases and recurrence (24, 25). Combining the study mentioned above, the phenomenon that less number of BRAF V600E mutations appears in patients aged under 25 years suggested that aggressive features displayed in these patients may not be caused by BRAF V600E mutation.…”

Section: Discussionmentioning

confidence: 99%

Relationship between BRAF V600E and clinical features in papillary thyroid carcinoma

Yan

Huang

et al. 2019

Endocrine Connections

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Objective To investigate the mutant status of BRAF gene and analyze its relationship to epidemiological risk factors and clinical outcomes among patients with papillary thyroid cancer (PTC) in the largest, single-institution Chinese cohort to date. Methods The medical records of 2048 PTC patients were reviewed in this retrospective study. Single-factor and multiple logistic regression analyses were applied to identify risk factors for BRAF V600E mutation. Survival outcomes including distant metastatic and persistent or recurrent PTC were examined, with a mean follow-up time of 23.4 (5–47) months. Results The BRAF V600E mutation was present in 83.7% of patients (1715 of 2048). Correlation was found between BRAF V600E mutation and several epidemiological features, including age, concomitant hypertension and Hashimoto thyroiditis (HT). For the clinicopathological features, BRAF V600E was significantly associated with bilateral multifocality (odds ratio (OR) 1.233, 95% confidence interval (CI) 1.063–1.431, P < 0.01) and less lateral lymph node metastases (OR 0.496, 95% CI 0.357–0.689, P < 0.01). Smaller tumor size and advanced disease stage were significant in single-factor analyses but became insignificant after multivariate adjustment. No association was found between BRAF V600E mutation and extrathyroidal invasion, distant metastatic and disease persistence or recurrence. Conclusion Part of epidemiological features are independent risk or protective factors for BRAF V600E mutation. The presence of BRAF V600E mutation is not an aggressive prognosis on poor clinical outcomes in PTC. However, the high prevalence of BRAF V600E may provide guidance for surgery strategy and opportunity for targeted treatment in recurrent and advanced stage disease.

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Section: Discussionmentioning

confidence: 99%

Relationship between BRAF V600E and clinical features in papillary thyroid carcinoma

Yan

Huang

et al. 2019

Endocrine Connections

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“…Transient hypocalcemia is one of the most common postoperative complications following thyroid surgery in clinical practice. 8 , 9 It has been reported that the rate of postoperative transient hypocalcemia ranges from 6% to 30%, 10 – 12 although there is ≤2% incidence of persistent dysfunction. The nadir of hypocalcemia often appears within 48 hours after thyroidectomy.…”

Section: Introductionmentioning

confidence: 99%

Risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy: a retrospective Chinese population study

Wang¹,

Bhandari²,

Yang³

et al. 2017

CMAR

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BackgroundHypocalcemia is one of the most common postoperative complications following thyroid surgery in clinical practice. The occurrence of hypocalcemia is mainly attributed to hypoparathyroidism when parathyroid glands are devascularized, injured, or dissected during the surgery. The aim of this study was to analyze the risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy.Patients and methodsA total of 278 patients who underwent thyroid surgery were analyzed retrospectively. Univariate analysis and multivariable logistic regression were performed to discover the risk factors for hypocalcemia and hypoparathyroidism.ResultsPostoperative hypocalcemia occurred in 76 (27.3%) patients and hypoparathyroidism occurred in 42 (15.1%) patients. Seven factors were significantly related to the presence of postoperative hypocalcemia, namely, age (P=0.049), gender (P=0.015), lateral lymph node dissection (P=0.017), operation type (P<0.001), preoperative parathyroid hormone (PTH) level (P=0.035), operation time (P=0.001), and applying carbon nanoparticles (CNs; P=0.007). Our result revealed that gender (P=0.014), lateral lymph node dissection (P=0.038), operation type (P<0.001), operative time (P<0.001), and applying CNs (P=0.001) had a significant correlation with postoperative hypoparathyroidism.ConclusionThese findings were crucial for guiding surgeons to prevent the occurrence of hypocalcemia and hypoparathyroidism.

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“…Al-Qurayshi et al recently reported, in agreement with prior analyses, 1,2 that children with thyroid cancer, though rare, more commonly present with metastatic and advanced disease and frequently require cervical lymph node dissections. 3 Perhaps as a response to this recognized difference, among others in pediatric thyroid disease presentation, the American Thyroid Association (ATA) recently released management guidelines for children with thyroid nodules and differentiated cancers. 4 These guidelines harbor the potential to influence practitioners whose treatment practices and surgical recommendations previously employed a more conservative approach to pediatric thyroid disease.…”

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confidence: 99%

Pediatric Thyroidectomy: Hospital Course and Perioperative Complications

Hanba

Svider

Siegel

et al. 2016

Otolaryngol.--head neck surg.

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Objectives/Hypothesis To evaluate hospital course and associated complications among pediatric patients undergoing thyroidectomy. Study Design and Setting Retrospective database review of the Kids' Inpatient Database (2009, 2012). Methods The Kids' Inpatient Database was evaluated for thyroidectomy patients for the years 2009 and 2012. Surgical procedure, patient demographics, length of stay, hospital charges (in US dollars), and surgical complications were evaluated. Results Of an estimated 1099 nationwide partial thyroidectomies and 1654 total thyroidectomies, females accounted for 73.5% and 79.1% of patients, respectively. Children <1 year of age had significantly longer hospital courses ( P < .0001), and patients 1 to 5 years of age had a significantly greater length of stay than individuals 6 to 20 years of age (7.8 vs 2.1 days, P < .001). The most common complications overall included hypocalcemia, respiratory complications, vocal cord paresis/paralysis, postoperative infection, and bleeding. Vocal cord paralysis was noted in 1.7% of pediatric thyroidectomy patients. The presence of these complications among total thyroidectomy patients significantly increased one's length of stay and hospital charges. A neck dissection was reported in 22.9% of malignant thyroidectomy patients. Conclusion Nearly 20% of children who underwent total thyroidectomy experienced postoperative hypocalcemia, positing a need for the development of postoperative calcium replacement algorithms to minimize the sequelae of hypocalcemia. A greater incidence of respiratory and infectious complications among younger patients (<6 years) suggests a need for closer monitoring, possibly encompassing routine postoperative intensive care unit utilization, in an attempt to minimize these sequelae.

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A National Perspective of the Risk, Presentation, and Outcomes of Pediatric Thyroid Cancer

Cited by 63 publications

References 22 publications

Relationship between BRAF V600E and clinical features in papillary thyroid carcinoma

Relationship between BRAF V600E and clinical features in papillary thyroid carcinoma

Risk factors for hypocalcemia and hypoparathyroidism following thyroidectomy: a retrospective Chinese population study

Pediatric Thyroidectomy: Hospital Course and Perioperative Complications

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