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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

Clinical characteristics and treatment of thyroid cancer in children and adolescents: a retrospective analysis of 83 patients

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.

Key words: Children and adolescents; Thyroid cancer; Clinical characteristics; Surgical treatment

Chinese Summary  <22> 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

目的:通过对青少年甲状腺癌患者的临床特征、治疗方法以及患者预后的分析和总结,为将来青少年甲状腺癌的治疗提供合理的治疗思路和方法。
创新点:回顾20年的青少年甲状腺癌患者的临床特征和治疗方式,分析治疗模式和观念的衍变,结合指南推荐,总结本中心对青少年甲状腺癌的治疗体会和经验,为青少年甲状腺癌患者提供更合理的治疗方式。
方法:回顾性分析本中心1990年1月至2010年12月期间收治的青少年甲状腺癌患者,并对其预后进行随访。根据年龄以12岁为界分成≤12岁和>12岁两组,分析两组患者的发病率、淋巴结转移、远处转移、腺外侵犯、治疗方法和预后情况。
结论:所有青少年甲状腺癌患者以分化型癌为主,小于12岁患者的淋巴结转移率要明显高于大于12岁组,同时在高龄组的患者中,女性的发病率要高于男性。在腺外侵犯、远处转移、死亡率以及复发性疾病等其他方面,两组无显著性差异。青少年甲状腺癌患者的总体预后较好,选择手术为主的综合性治疗方式将会得到较为满意的效果。

关键词组:青少年;甲状腺癌;临床特征;手术治疗


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DOI:

10.1631/jzus.B1600308

CLC number:

R736.1

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On-line Access:

2017-05-04

Received:

2016-07-05

Revision Accepted:

2016-08-26

Crosschecked:

2017-04-10

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