1937P - Clinical characteristics and prognosis of pediatric patients with papillary thyroid carcinoma

Background

To clarify the clinicopathological features and clinical outcomes of histological subtypes of papillary thyroid carcinoma (PTC) in the pediatric and adolescent population treated at a single institution.

Methods

A total of 153 PTC patients ≤18 years of age who underwent initial surgery between 1979 and 2019 were investigated. The most common subtypes included classic PTC in 124 (81%), solid variant in 16 (10%), diffuse sclerosing variant in 7 (5%), and follicular variant in 6 (4%). Cause-specific survival (CSS) and disease-free survival (DFS) rates were calculated by the Kaplan–Meier method.

Results

There were 135 female and 18 male patients, with a mean age at the time of surgery of 16 (range, 8-18) years, and 5% (8 patients) were ≤10 years of age at diagnosis. At initial surgery, 49 patients (32%) had lymph node metastases diagnosed preoperatively (cN1), 16 (10%) had gross extrathyroidal extension (ETE), and 18 (12%) had lung metastases. Total thyroidectomy was performed in 55 (36%) patients, and 98 (64%) patients underwent less than total thyroidectomy. During a mean follow-up of 16 years, 3 patients died of their disease, and 34 patients had recurrent disease. The 30-year CSS rate was 97.2%, and the 30-year DFS rate was 65.0%. On univariate analysis, extensive ETE (p=0.001) and cN1 (p=0.003), but not histological subtype (p=0.21), were associated with disease recurrence. Extensive ETE and cN1 were identified as significant factors related to DFS on multivariate analysis (hazard ratio (HR) 5.2, confidence interval (CI) 1.9-12.4, p=0.0028; HR 3.2, CI.6-6.6, p=0.0021).

Conclusions

The prognosis of pediatric patients with PTC was good, but recurrence was common. In pediatric PTC, histological subtype did not affect survival and recurrence.

Clinical trial identification

Editorial acknowledgement

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.