Young age is associated with increased rates of residual and recurrent paediatric differentiated thyroid carcinoma

Hampson, Sarah E.; Stephens, Derek; Wasserman, Jonathan D.

doi:10.1111/cen.13720

Cited by 13 publications

(11 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12,21 Lastly, we had nearly a 5:1 female predominance, similar to previous studies. However, a score ≥2 had good specificity for detecting thyroid cancer (85.1%) though the sensitivity was poor (22.7%).…”

Section: Clinical Featuressupporting

confidence: 88%

“…While young age is associated with a higher chance of persistent disease or recurrence, we did not find it affected the likelihood of malignancy, though it is thought that young children overall may have worse outcomes compared to adolescents given the same cancer burden. 12,21 Lastly, we had nearly a 5:1 female predominance, similar to previous studies. 9,22,23 We did find a significant difference in TSH levels between patients with malignant and benign nodules.…”

Section: Clinical Featuressupporting

confidence: 88%

See 1 more Smart Citation

Diagnostic accuracy of the McGill thyroid nodule score in paediatric patients

Creo

Alahdab

Nofal

et al. 2018

Clinical Endocrinology

View full text Add to dashboard Cite

Introduction Thyroid cancer is the most common paediatric endocrine cancer; accurate diagnosis and prompt management of paediatric thyroid nodules is critical. The McGill Thyroid Nodule Score (MTNS), based upon clinical, ultrasound (US) and cytology criteria, has recently been modified and studied in a pilot paediatric group with good results. We aim to describe the diagnostic accuracy of the paediatric modified MTNS (PMTNS) in a large paediatric cohort. Methods We utilized an established retrospective cohort between 1996 and 2015 of 99 patients ≤21 years old with 131 thyroid nodules. Two experienced paediatric radiologists, blinded to pathology and radiology reports, reviewed US features. We abstracted cytology, histology and laboratory results, assigning each nodule a PMTNS. PMTNS performance was compared to FNA and histology. Results Approximately 33% of nodules were malignant. The cohort was predominantly adolescent (mean age 15.4 ± 3.8 years). The average PMTNS for malignant and benign nodules, based on final histology, was 12.7 ± 4.3 and 1.7 ± 2.9, respectively. A PMTNS ≥8 resulted in a 93.2% sensitivity and 93.1% specificity for detecting malignancy, while a PMTNS ≥9 resulted in a 90.9% sensitivity and 96.6% specificity. However, Bethesda cytology category ≥4 independently had a 97.7% sensitivity and 94.0% specificity for detecting malignancy. The PMTNS had diminishing diagnostic accuracy in younger children compared with older children. Conclusion Paediatric modified McGill Thyroid Nodule Score predicts malignancy, perhaps due to the score's emphasis on cytology results; however, the score is less accurate in younger patients. While cytology results remain reliable, further work is needed to develop a non‐invasive scoring system to predict malignancy in children.

show abstract

Section: Clinical Featuressupporting

confidence: 88%

Section: Clinical Featuressupporting

confidence: 88%

Diagnostic accuracy of the McGill thyroid nodule score in paediatric patients

Creo

Alahdab

Nofal

et al. 2018

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

“…Despite the findings of these studies, some authors found no association between puberty and clinical and pathological features in DTC ( 10 , 25 ). In agreement with previous studies ( 5 , 21 , 22 , 26 , 27 ), structural disease at the end of follow-up was more prevalent in prepubertal patients, despite no difference in the long-term disease-free survival rate.…”

Section: Discussionsupporting

confidence: 92%

“…Other authors have also shown increased aggressiveness at presentation in patients diagnosed with DTC before puberty ( 4 , 5 , 6 , 20 , 21 , 22 , 23 , 24 ). In a sample of 27 pediatric patients, including 10 prepubertal patients, Lazar et al found nodal metastasis at diagnosis in all prepubertal patients and distant metastasis in 70% of them ( 4 ).…”

Section: Discussionmentioning

confidence: 81%

Puberty and sex in pediatric thyroid cancer: could expression of estrogen and progesterone receptors affect prognosis?

Breder

Junior

Araujo

et al. 2022

European Thyroid Journal

View full text Add to dashboard Cite

Objective: A sharp increase in pediatric thyroid cancer incidence is observed during adolescence, driven mainly by girls. Differences in disease presentation across sexual maturity stages raise the question of whether sex steroids have a role in the heterogeneity. The aims of this study were to analyze the influence of puberty and sex on clinical presentation and prognosis and to evaluate the correlation between the expression of sex hormone receptors. Design and methods: Clinical records and immunohistochemical of specimens from 79 patients was analyzed. Puberty was analyzed by two criteria: end of puberty and beginning, in which the age of 10 was the cutoff. Results: Postpubertal were more frequently classified as having low-risk disease and a lower frequency of persistent disease, especially when the completion of puberty was used as the criteria. Male sex was associated with a higher risk of persistent disease at the end of the observation period. ERα positivity was low in the entire sample, while progesterone receptor positivity was positive in 30% of the cases. Hormone receptor expression was not associated with sex, ATA risk score, persistent disease, or pubertal status. Conclusion: Our study showed that the best way to study puberty retrospectively is to use clinical events that represent the conclusion of this process and conclusion of puberty might be better prognostic factor. It was also shown that postpubertal patients have less aggressive initial presentation and better outcomes. However, this observation could not be explained by the expression of estrogen and progesterone receptors in the tumors.

show abstract

“…Differentiated thyroid carcinoma is frequently more advanced at diagnosis in pre-pubertal children when compared to adolescents and adults, although the long-term prognosis is highly favourable for both children and adolescents [ 79 , 80 , 81 ].…”

Section: Differentiated Thyroid Carcinoma (Dtc)mentioning

confidence: 99%

Canadian Consensus for Biomarker Testing and Treatment of TRK Fusion Cancer in Pediatric Patients

et al. 2021

Self Cite

View full text Add to dashboard Cite

Neurotrophic tyrosine receptor kinase gene fusions (NTRK) are oncogenic drivers present at a low frequency in most tumour types (<5%), and at a higher frequency (>80%) in a small number of rare tumours (e.g., infantile fibrosarcoma [IFS]) and considered mutually exclusive with other common oncogenic drivers. Health Canada recently approved two tyrosine receptor kinase (TRK) inhibitors, larotrectinib (for adults and children) and entrectinib (for adults), for the treatment of solid tumours harbouring NTRK gene fusions. In Phase I/II trials, these TRK inhibitors have demonstrated promising overall response rates and tolerability in patients with TRK fusion cancer who have exhausted other treatment options. In these studies, children appear to have similar responses and tolerability to adults. In this report, we provide a Canadian consensus on when and how to test for NTRK gene fusions and when to consider treatment with a TRK inhibitor for pediatric patients with solid tumours. We focus on three pediatric tumour types: non-rhabdomyosarcoma soft tissue sarcoma/unspecified spindle cell tumours including IFS, differentiated thyroid carcinoma, and glioma. We also propose a tumour-agnostic consensus based on the probability of the tumour harbouring an NTRK gene fusion. For children with locally advanced or metastatic TRK fusion cancer who have either failed upfront therapy or lack satisfactory treatment options, TRK inhibitor therapy should be considered.

show abstract

Young age is associated with increased rates of residual and recurrent paediatric differentiated thyroid carcinoma

Abstract: Despite comparable apparent initial disease burden and treatment, younger children have poorer outcomes when compared to adolescents, even in the absence of nodal metastases and thus may warrant intensification of primary therapy and/or tumour surveillance.

Cited by 13 publications

References 22 publications

Diagnostic accuracy of the McGill thyroid nodule score in paediatric patients

Diagnostic accuracy of the McGill thyroid nodule score in paediatric patients

Puberty and sex in pediatric thyroid cancer: could expression of estrogen and progesterone receptors affect prognosis?

Canadian Consensus for Biomarker Testing and Treatment of TRK Fusion Cancer in Pediatric Patients

Contact Info

Product

Resources

About