Tumor size is an independent negative prognostic factor for event free survival in children with differentiated thyroid cancer

Parvathareddy, Sandeep Kumar; Siraj, Abdul K.; Annaiyappanaidu, Padmanaban; Siraj, Nabil; Haqawi, Wael; Al-Sobhi, Saif S.; Al‐Dayel, Fouad; Al‐Kuraya, Khawla S.

doi:10.3389/fendo.2022.979054

Cited by 9 publications

(7 citation statements)

References 35 publications

(44 reference statements)

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“…In a cohort of 88 pediatric DTCs with mean follow‐up of 8.4 years, Parvathareddy et al. did not observe any significant difference in the long‐term event‐free survival between the less than or equal to 15 years and more than 15 years age groups 19 . Similarly, Cistaro et al.…”

Section: Discussionmentioning

confidence: 90%

“…In a cohort of 88 pediatric DTCs with mean follow-up of 8.4 years, Parvathareddy et al did not observe any significant difference in the long-term event-free survival between the less than or equal to 15 years and more than 15 years age groups. 19 Similarly, Cistaro et al evaluated pediatric DTC patients over a median follow-up of approximately 11 years, and did not find age as a continuous variable to be predictive of long-term disease-free status.…”

Section: Discussionmentioning

confidence: 99%

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Appropriateness of 14‐year cutoff in pediatric differentiated thyroid cancer: Comparison of clinical characteristics and long‐term outcomes in 14 years and younger and 15–18 years age groups

Satapathy

Majeed

Ballal

et al. 2023

Pediatric Blood & Cancer

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BackgroundPediatric differentiated thyroid cancers (DTCs) differ in pathophysiology, presentation, and clinical outcomes from adult DTCs. However, the cutoff age for defining pediatric DTCs remains debatable, with the American Thyroid Association (ATA) and International Incidence of Childhood Cancer (IICC) report recommending different cutoffs of 18 and 14 years, respectively. In this study, we investigated the appropriateness of 14‐year cutoff by comparing the clinical characteristics and long‐term outcomes in the 14 years and younger and 15–18 years age groups.MethodsData of DTC patients, aged 18 years and older, from 1981 to 2016, were sequentially extracted and compared between two age groups: ≤14 and 15–18 years.ResultsTotal of 176 pediatric DTC patients were included (age group ≤14 years: n = 75; age group 15–18 years: n = 101). None of the baseline clinical characteristics were significantly different between the two age groups. At 2‐year follow‐up, patients in the age group ≤14 years had significantly higher incomplete response rate compared to those in the age group 15–18 years (69% vs. 42%, respectively, p < .001). However, over a median follow‐up of 10.6 years (interquartile range: 7.7–15.5), the 5‐ and 10‐year Disease‐free survival (DFS) probabilities were not significantly different (p = .406). On multivariate analysis, incomplete response at 2‐year follow‐up was the sole independent predictor of poor DFS (hazard ratio: 5.85, 95% confidence interval: 1.69–20.23).ConclusionsSubdivision of pediatric DTCs into less than or equal to 14 years and 15–18 years age groups did not have any long‐term predictive value. The cutoff of 18 years as recommended by ATA is reasonable and should be uniformly followed to avoid inconsistencies and confusion.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Appropriateness of 14‐year cutoff in pediatric differentiated thyroid cancer: Comparison of clinical characteristics and long‐term outcomes in 14 years and younger and 15–18 years age groups

Satapathy

Majeed

Ballal

et al. 2023

Pediatric Blood & Cancer

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“…[1,5,7,14,17] Our study also found a similar result that younger age was associated with higher TI-RADS, higher pN stage, higher ATA pediatric risk, and multifocality (all P < .05). Children with DTC often need a wider range of cervical lymph node dissection, and more iodine-131 radiotherapy Parvathareddy SK [37] (2022) (P < .05). However, there was no significant difference between the 2 groups in pT/pM stage and bilaterality in our study, possibly because of the limited sample size.…”

Section: Comparison Of Clinicopathological Features and Treatments Of...mentioning

confidence: 99%

Risk factors for recurrence of differentiated thyroid carcinoma in children and adolescents: A retrospective cohort study

Jia,

Tang,

Peng

2023

Medicine

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This study aimed to provide a recent clinical evaluation of the outcome of treatment and the predictors of recurrence for Chinese children and adolescents with differentiated thyroid carcinoma (DTC). This is a retrospective cohort study at the Yunnan Cancer Hospital from May 2002 to August 2021. We analyzed several risk factors related to the recurrence of DTC in children and adolescents. The Chi-square test, Kaplan–Meier log-rank tests, and Cox regression analysis were used in the statistical analysis. A P-value <.05 was considered statistically significant. A total of 103 patients were enrolled, including 68 girls (66.0%) and 35 boys (34.0%) with a median age of 18 years (range: 7–20 years). All enrolled patients received standard treatment. Children (≤14years) tended to have multifocality and higher levels of thyroid imaging reporting and data system, higher pN stage, and higher American Thyroid Association (ATA) pediatric risk compared with adolescents (P < .05). The chief complaints and clinical treatment differed between children and adolescents. During a follow-up of 6 to 239 months (average 74.7 months, median 59 months), all patients survived, but recurrence occurred in 22 patients (22.4%). The disease-free survival rates at 1, 2, 5, and 10 years were 91.2%, 78.4%, 77.1%, and 77.1%, respectively. Univariate Cox regression and log-rank tests showed that positive preoperative thyroglobulin level, bilaterality, extrathyroidal extension, high pT/pN/pM stage, and high ATA pediatric risk were the risk factors for DTC recurrence in children and adolescents. Multivariate Cox regression found that extrathyroidal extension and ATA pediatric risk were independent risk factors for the recurrence of DTC in children and adolescents. Additionally, among the 38 cases with cN0 stage, one who had bilateral, and multifocal thyroid nodules experienced recurrence, while the remaining 37 cases with cN0 stage had no recurrence. In conclusion, compared with adolescents, children present with more highly malignant disease and are more prone to metastasis. The significant risk factors associated with the recurrence of DTC in children and adolescents were positive preoperative thyroglobulin level, bilaterality, high pT/pN/pM stage, extrathyroidal extension, and high ATA pediatric risk, with the latter 2 being independent risk factors. The surgical approach for cN0 patients should be personalized taking into account invasive features.

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“…According to the eighth edition of the AJCC-TNM staging system, ETE for thyroid carcinomas was divided into minimal and gross ETE. Minimal ETE is defined as the tumor invasion of the perithyroid soft tissue, while gross ETE refers to invasion into strap muscles and major neck structures (subcutaneous soft tissue, larynx, trachea, esophagus, recurrent laryngeal nerve, the prevertebral fascia, or it encases the carotid artery or mediastinal vessels) [9][10][11]. Surgery is the most effective means of routinely treating PTC.…”

Section: Introductionmentioning

confidence: 99%

Predicting Extrathyroidal Extension in Papillary Thyroid Carcinoma Using a Clinical-Radiomics Nomogram Based on B-Mode and Contrast-Enhanced Ultrasound

et al. 2023

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Papillary thyroid carcinoma (PTC) is the most common pathological type of thyroid cancer. PTC patients with extrathyroidal extension (ETE) are associated with poor prognoses. The preoperative accurate prediction of ETE is crucial for helping the surgeon decide on the surgical plan. This study aimed to establish a novel clinical-radiomics nomogram based on B-mode ultrasound (BMUS) and contrast-enhanced ultrasound (CEUS) for the prediction of ETE in PTC. A total of 216 patients with PTC between January 2018 and June 2020 were collected and divided into the training set (n = 152) and the validation set (n = 64). The least absolute shrinkage and selection operator (LASSO) algorithm was applied for radiomics feature selection. Univariate analysis was performed to find clinical risk factors for predicting ETE. The BMUS Radscore, CEUS Radscore, clinical model, and clinical-radiomics model were established using multivariate backward stepwise logistic regression (LR) based on BMUS radiomics features, CEUS radiomics features, clinical risk factors, and the combination of those features, respectively. The diagnostic efficacy of the models was assessed using receiver operating characteristic (ROC) curves and the DeLong test. The model with the best performance was then selected to develop a nomogram. The results show that the clinical-radiomics model, which is constructed by age, CEUS-reported ETE, BMUS Radscore, and CEUS Radscore, showed the best diagnostic efficiency in both the training set (AUC = 0.843) and validation set (AUC = 0.792). Moreover, a clinical-radiomics nomogram was established for easier clinical practices. The Hosmer–Lemeshow test and the calibration curves demonstrated satisfactory calibration. The decision curve analysis (DCA) showed that the clinical-radiomics nomogram had substantial clinical benefits. The clinical-radiomics nomogram constructed from the dual-modal ultrasound can be exploited as a promising tool for the pre-operative prediction of ETE in PTC.

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Tumor size is an independent negative prognostic factor for event free survival in children with differentiated thyroid cancer

Cited by 9 publications

References 35 publications

Appropriateness of 14‐year cutoff in pediatric differentiated thyroid cancer: Comparison of clinical characteristics and long‐term outcomes in 14 years and younger and 15–18 years age groups

Appropriateness of 14‐year cutoff in pediatric differentiated thyroid cancer: Comparison of clinical characteristics and long‐term outcomes in 14 years and younger and 15–18 years age groups

Risk factors for recurrence of differentiated thyroid carcinoma in children and adolescents: A retrospective cohort study

Predicting Extrathyroidal Extension in Papillary Thyroid Carcinoma Using a Clinical-Radiomics Nomogram Based on B-Mode and Contrast-Enhanced Ultrasound

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