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

BACKGROUND: Thyroid 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 ionizi...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354958/
https://www.ncbi.nlm.nih.gov/pubmed/35935364
http://dx.doi.org/10.3389/fped.2022.914942
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author 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
author_facet 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
author_sort Martucci, Cristina
collection PubMed
description BACKGROUND: Thyroid 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. METHODS: Institutional 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. RESULTS: Among 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). CONCLUSIONS: This 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%).
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spelling pubmed-93549582022-08-06 Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors 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 Front Pediatr Pediatrics BACKGROUND: Thyroid 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. METHODS: Institutional 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. RESULTS: Among 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). CONCLUSIONS: This 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%). Frontiers Media S.A. 2022-07-22 /pmc/articles/PMC9354958/ /pubmed/35935364 http://dx.doi.org/10.3389/fped.2022.914942 Text en Copyright © 2022 Martucci, Crocoli, De Pasquale, Spinelli, Strambi, Brazzarola, Morelli, Cassiani, Mancera, Luengas, Lobos, Liberto, Astori, Sarnacki, Couloigner, Simon, Lambert, Abib, Cervantes, Caran, Delgado Lindman, Jones, Shukla, Losty and Inserra. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
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
Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors
title Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors
title_full Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors
title_fullStr Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors
title_full_unstemmed Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors
title_short Thyroid cancer in children: A multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors
title_sort thyroid cancer in children: a multicenter international study highlighting clinical features and surgical outcomes of primary and secondary tumors
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9354958/
https://www.ncbi.nlm.nih.gov/pubmed/35935364
http://dx.doi.org/10.3389/fped.2022.914942
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