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Clinical features of thyroid cancer in paediatric age. Experience of a tertiary centre in the 2000–2020 period

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Abstract

Purpose

To describe the clinical features of a paediatric cohort affected by differentiated thyroid cancer (DTC) followed in a tertiary Department of Paediatric Endocrinology.

Methods

Clinical data of 41 patients affected by DTC in the 2000–2020 period were reviewed.

Results

The main risk factor was autoimmune thyroiditis (39%). Cytological categories were TIR3b in 39%, TIR4 in 9.8%, TIR5 in 51.2%. After total thyroidectomy, radioiodine treatment was performed in 38 subjects (92.7%). ATA low-risk category was assigned in 11 (30.5%), intermediate-risk category in 15 (41.7%), and high-risk category in 10 patients (27.8%). Age at diagnosis was 15.1 ± 0.92 years in low-risk category, 14.7 ± 0.59 in intermediate-risk category, 11.7 ± 0.89 years in high-risk category (p = 0.01). TIR3b was manly observed in low-risk class (63.6%), while TIR5 was mainly reported in intermediate and high-risk class (60 and 80% respectively) (p = 0.04). Post-surgery stimulated thyroglobulin was increased in high-risk class (407.8 ± 307.1 ng/ml) [p = 0.04]. Tumour size was larger in high-risk category (42.6 ± 2.6 mm), than in low and intermediate-risk categories (19.4 ± 3.5 mm and 28.5 ± 3.9 mm, respectively) (p = 0.008). Patients in intermediate and high-risk categories displayed more tumour multifocality (60 and 90% respectively) (p < 0.005). Disease relapse was mainly observed in high risk category (40%, p = 0.04).

Conclusion

DTC in childhood is more aggressive than in adults, but the overall survival rate is excellent. The therapeutic approach is still heterogeneous, especially in low-risk category. Further studies are needed to standardise management and reduce disease persistence in childhood.

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Authors and Affiliations

  1. Department of Public Health and Pediatrics, University of Turin, Turin, Italy

    Gerdi Tuli, Jessica Munarin, Patrizia Matarazzo, Antonio Marino, Andrea Corrias & Luisa De Sanctis

  2. Department of Pediatric Endocrinology, Regina Margherita Children’s Hospital, Turin, Italy

    Antonio Marino

  3. Candiolo Cancer Institute, FPO-IRCCS, Turin, Italy

    Nicola Palestini

  4. Department of General Surgery, Maria Vittoria Hospital, ASL City of Turin, Turin, Italy

    Francesco Quaglino

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All authors contributed to the study design and conception. Material preparation, data collection and analysis were performed by A.M., J.M. and G.T. The clinical management of the enroled subjects was managed by A.C., P.M., G.T., J.M., F.Q. and L.D. Sanctis. The first draft of the manuscript was written by G.T. and J.M. and all authors have commented on previous versions of the manuscript. All authors have read and approved the final manuscript.

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Correspondence to Gerdi Tuli.

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Tuli, G., Munarin, J., Matarazzo, P. et al. Clinical features of thyroid cancer in paediatric age. Experience of a tertiary centre in the 2000–2020 period. Endocrine 81, 322–329 (2023). https://doi.org/10.1007/s12020-023-03366-y

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