Abstract: Objective: To study the clinical characteristics, treatment, and prognosis of thyroid cancer in children and adolescents. Methods: We performed a retrospective analysis of clinical data from 83 cases of thyroid cancer in children and adolescents from January 1990 to December 2010. We compared extra-thyroid extension, lymph node metastasis, distant metastasis, and prognosis between pediatric patients ≤12 years of age (27 cases) and those >12 years of age (56 cases). All the patients agreed to undergo thyroidectomy and endocrine therapy, and the consent was obtained from parents or guardians. Results: Histopathology included papillary carcinoma in 67 cases, papillary carcinoma with partial follicular growth pattern in 1 case, papillary carcinoma with squamous metaplasia in 4 cases, follicular carcinoma in 7 cases, medullary carcinoma in 3 cases, and poorly differentiated carcinoma in 1 case. The total lymph node metastasis rate was 78.31%. Patients ≤12 years of age showed a higher rate of lymph node metastasis than the older group (92.59% vs. 71.43%, P=0.028). The incidence rate in females in the older group was higher than that in the younger group (80.36% vs. 59.26%, P=0.041). There were no significant differences in extra-thyroid extension, distant metastasis, survival rate, or recurrent disease between the two groups. Conclusions: The lymph node metastasis of thyroid cancer is higher in patients ≤12 years of age than in those >12 years of age; the incidence rate is higher in females than in males. Childhood thyroid cancer has a good prognosis, surgery being the most effective treatment. Choosing a reasonable surgery method and comprehensive postoperative treatment can achieve a cure and satisfactory survival rate.

回顾性分析83例青少年甲状腺癌患者的临床特征和治疗体会

[1]Adam, M.A., Pura, J., Gu, L., et al., 2014. Extent of surgery for papillary thyroid cancer is not associated with survival: an analysis of 61 775 patients. Ann. Surg., 260(4):601-607.

[2]Alessandri, A.J., Goddard, K.J., Blair, G.K., et al., 2000. Age is the major determinant of recurrence in pediatric differentiated thyroid carcinoma. Med. Pediatr. Oncol., 35(1):41-46.

[3]Atabek, M.E., 2011. What is the safe and accurate procedure for thyroid nodules in childhood? Horm. Res. Paediatr., 76(1):72.

[4]Baş, V.N., Aycan, Z., Çetinkaya, S., et al., 2012. Thyroid nodules in children and adolescents: a single institution’s experience. J. Pediatr. Endocrinol. Metab., 25(7-8):633-638.

[5]Dzepina, D., 2012. Surgical and pathological characteristics of papillary thyroid cancer in children and adolescents. Int. J. Pediatr., 2012:125389.

[6]Dzodic, R., Buta, M., Markovic, I., et al., 2014. Surgical management of well-differentiated thyroid carcinoma in children and adolescents: 33 years of experience of a single institution in Serbia. Endocr. J., 61(11):1079-1086.

[7]Edge, S.B., Compton, C.C., 2010. The American Joint Committee on Cancer: the 7th edition of the AJCC Cancer Staging Manual and the future of TNM. Ann. Surg. Oncol., 17(6):1471-1474.

[8]Francis, G.L., Waguespack, S.G., Bauer, A.J., et al., 2015. Management guidelines for children with thyroid nodules and differentiated thyroid cancer. Thyroid, 25(7):716-759.

[9]Grigsby, P.W., Gal-or, A., Michalski, J.M., et al., 2002. Childhood and adolescent thyroid carcinoma. Cancer, 95(4):724-729.

[10]Gupta, A., Ly, S., Castroneves, L.A., et al., 2013. A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults. J. Clin. Endocrinol. Metab., 98(8):3238-3245.

[11]Jing, F.J., Liang, Z.Y., Long, W., et al., 2013. Invasive capacity of differentiated thyroid carcinoma in pediatric and adolescent patients. Acta Acad. Med. Sin., 35(1):80-83 (in Chinese).

[12]Kloos, R.T., Eng, C., Evans, D.B., et al., 2009. Medullary thyroid cancer: management guidelines of the American Thyroid Association. Thyroid, 19(6):565-612.

[13]Leboulleux, S., Hartl, D., Baudin, E., et al., 2012. Differentiated thyroid cancer in childhood. Bull. Cancer, 99(11): 1093-1099 (in French).

[14]Mihailovic, J., Stefanovic, L., Malesevic, M., 2007. Differentiated thyroid carcinoma with distant metastases: probability of survival and its predicting factors. Cancer Biother. Radiopharm., 22(2):250-255.

[15]Mihailovic, J., Stefanovic, L., Malesevic, M., et al., 2009. The importance of age over radioiodine avidity as a prognostic factor in differentiated thyroid carcinoma with distant metastases. Thyroid, 19(3):227-232.

[16]Mihailovic, J., Nikoletic, K., Srbovan, D., 2014. Recurrent disease in juvenile differentiated thyroid carcinoma: prognostic factors, treatments, and outcomes. J. Nucl. Med., 55(5):710-717.

[17]O'Gorman, C.S., Hamilton, J., Rachmiel, M., et al., 2010. Thyroid cancer in childhood: a retrospective review of childhood course. Thyroid, 20(4):375-380.

[18]Osipoff, J.N., Wilson, T.A., 2012. Consultation with the specialist: thyroid nodules. Pediatr. Rev., 33(2):75-81; quiz 82.

[19]Patron, V., Bedfer, C., le Clech, G., et al., 2011. Pattern of lateral neck metastases in N0 papillary thyroid carcinoma. BMC Cancer, 11:8.

[20]Schlumberger, M., Sherman, S.I., 2012. Approach to the patient with advanced differentiated thyroid cancer. Eur. J. Endocrinol., 166(1):5-11.

[21]Vaisman, F., Corbo, R., Vaisman, M., 2011. Thyroid carcinoma in children and adolescents—systematic review of the literature. J. Thyroid Res., 2011:845362.

[22]Ward, L.S., Marrone, M., Camargo, R.Y., et al., 2006. Low-risk differentiated thyroid carcinoma—literature review and management guidelines. Arq. Bras. Endocrinol. Metabol., 50(3):550-557 (in Portuguese).