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Abstract
The management of differentiated thyroid cancer in childhood is controversial. In
particular, the role of aggressive surgical treatment has been questioned. This study
was performed to identify those factors that are predictive of recurrence and morbidity
following treatment through use of a multivariate model. The records of all patients
17 years of age or less admitted in the last 35 years with histologically confirmed
differentiated thyroid carcinoma were reviewed. Data were sufficient for multivariate
analysis in 93. The mean age at diagnosis was 13.3 years, and the median period of
follow-up was 20 years. Seventy-one percent of the patients had nodal metastases.
There were no deaths from thyroid carcinoma in this series, and the overall recurrence
rate after initial treatment was 34%. Multivariate analysis demonstrated that only
age (p ≤ 0.07) and histologic subtype (p ≤ 0.01) were predictive of time to recurrence.
Major morbidity was a function of age (p ≤ 0.007) and extent of thyroid surgery (p
≤ 0.01). Probability of minor complications was predicted by use of radical neck dissection
(p ≤ 0.02). Use of total or subtotal thyroidectomy or of radical neck dissection in
children does not prevent recurrence and is associated with an increased risk of complications.
We conclude that these procedures should be avoided in pediatric patients.
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Article info
Footnotes
☆Presented at the Ninth Annual Meeting of the American Association of Endocrine Surgeons, Boston, Mass., April 24–26, 1988.
Identification
Copyright
© 1988 Published by Elsevier Inc.
