Pediatric papillary thyroid cancer >1 cm: is total thyroidectomy necessary?

Abstract:

PURPOSE:Treatment of pediatric papillary thyroid cancer (p-PTC) often follows adult guidelines, including total thyroidectomy for tumors >1cm. This study examined the association between operation type and overall survival (OS) for tumors >1cm in size in the pediatric population. METHODS:Patients ≤ 21 years of age with primary papillary thyroid cancer >1cm were reviewed from the National Cancer Data Base (NCDB) from 1998 to 2011. Kaplan-Meier analysis followed by Cox proportional hazard models estimated the impact of total thyroidectomy (TT) vs. partial thyroidectomy (PT) on overall survival. Models were adjusted for patient, tumor, and treatment factors. RESULTS:3,861 cases (3474 TT, 387 PT) were included. Estimated 15-year overall survival was 96.10% after TT and 96.18% after PT (p=0.0855). In multivariate analysis of 3173 patients, only lowest socioeconomic level (HR 4.93, p=0.001) and unfavorable histology (HR 6.11, p=0.016) were associated with worse OS. Survival for patients undergoing TT was not statistically improved over those undergoing PT (HR 0.81, p=0.694). CONCLUSION:p-PTC >1cm has an excellent 15-year overall survival. Treatment with TT did not have an improved OS compared to PT. Lower socioeconomic status and unfavorable histology were associated with decreased OS.

journal_name

J Pediatr Surg

authors

Nice T,Pasara S,Goldfarb M,Doski J,Goldin A,Gow KW,Nuchtern JG,Vasudevan SA,Langer M,Beierle EA

doi

10.1016/j.jpedsurg.2015.03.031

subject

Has Abstract

pub_date

2015-06-01 00:00:00

pages

1009-13

issue

6

eissn

0022-3468

issn

1531-5037

pii

S0022-3468(15)00202-X

journal_volume

50

pub_type

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