Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors

BackgroundThyroid gland malignancies are rare in pediatric patients (0.7% of tumors); only 1.8% are observed in patients aged <20 years, with a higher prevalence recorded in women and adolescents. Risk factors include genetic syndromes, MEN disorders, autoimmune diseases, and exposure to ionizing...

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Published in:	Frontiers in pediatrics Vol. 10; p. 914942
Main Authors:	Martucci, Cristina, Crocoli, Alessandro, De Pasquale, Maria Debora, Spinelli, Claudio, Strambi, Silvia, Brazzarola, Paolo, Morelli, Eleonora, Cassiani, Jessica, Mancera, Juliana, Luengas, Juan Pablo, Lobos, Pablo, Liberto, Daniel, Astori, Estefanìa, Sarnacki, Sabine, Couloigner, Vincent, Simon, François, Lambert, Cassandre, Abib, Simone de Campos Vieira, Cervantes, Onivaldo, Caran, Eliana, Delgado Lindman, Diana, Jones, Matthew O., Shukla, Rajeev, Losty, Paul D., Inserra, Alessandro
Format:	Journal Article
Language:	English
Published:	Frontiers Media S.A 22-07-2022
Subjects:	cancer carcinoma children Pediatrics surgery thyroid
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Summary:	BackgroundThyroid gland malignancies are rare in pediatric patients (0.7% of tumors); only 1.8% are observed in patients aged <20 years, with a higher prevalence recorded in women and adolescents. Risk factors include genetic syndromes, MEN disorders, autoimmune diseases, and exposure to ionizing radiation. Radiotherapy is also associated with an increased risk of secondary thyroid cancer. This study describes the clinical features and surgical outcomes of primary and secondary thyroid tumors in pediatric patients. MethodsInstitutional data were collected from eight international surgical oncology centers for pediatric patients with thyroid cancer between 2000 and 2020. Statistical analyses were performed using the GraphPad Prism software. ResultsAmong 255 total cases of thyroid cancer, only 13 (5.1%) were secondary tumors. Primary thyroid malignancies were more likely to be multifocal in origin (odds ratio [OR] 1.993, 95% confidence interval [CI].7466-5.132, p = 0.2323), have bilateral glandular location (OR 2.847, 95% CI.6835-12.68, p = 0.2648), and be metastatic at first diagnosis (OR 1.259, 95% CI.3267-5.696, p > 0.999). Secondary tumors showed a higher incidence of disease relapse (OR 1.556, 95% CI.4579-5.57, p = 0.4525) and surgical complications (OR 2.042, 95% CI 0.7917-5.221, p = 0.1614), including hypoparathyroidism and recurrent laryngeal nerve injury. The overall survival (OS) was 99% at 1 year and 97% after 10 years. No EFS differences were evident between the primary and secondary tumors (chi-square 0.7307, p = 0.39026). ConclusionsThis multicenter study demonstrated excellent survival in pediatric thyroid malignancies. Secondary tumors exhibited greater disease relapse (15.8 vs. 10.5%) and a higher incidence of surgical complications (36.8 vs. 22.2%).
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 This article was submitted to Pediatric Surgery, a section of the journal Frontiers in Pediatrics Reviewed by: Celine Richard, St. Jude Children's Research Hospital, United States; Nada Santrac, Institute of Oncology and Radiology of Serbia, Serbia; Ana Catarina Fragoso, University of Porto, Portugal Edited by: Antonino Morabito, University of Florence, Italy
ISSN:	2296-2360 2296-2360
DOI:	10.3389/fped.2022.914942