E. A. Perez1, J. Tashiro1, S. Golpanian1, J. I. Lew2, H. I. Neville1, A. R. Hogan1, J. E. Sola1 1University Of Miami Miller School Of Medicine,DeWitt Daughtry Family, Department Of Surgery, Division Of Pediatric Surgery,Miami, FL, USA 2University Of Miami,Division Of Endocrine Surgery, DeWitt Daughtry Family, Department Of Surgery,,Miami, FL, USA
Introduction: To update outcomes and predictors of survival on pediatric thyroid carcinoma, specifically examining pediatric patients with non-papillary thyroid carcinoma.
Methods: Surveillance, Epidemiology, and End Results database was searched for pediatric cases (<20 yrs old) of non-papillary thyroid carcinoma diagnosed between 1973 and 2011. Demographics, clinical characteristics, and survival outcomes were analyzed using standard statistical methods. All follicular, medullary, Hurthle cell, and nonencapsulated sclerosing carcinoma types were included in the data set.
Results: A total of 504 cases were identified. Overall incidence was 0.096/100,000 persons per year. Mean age at diagnosis was 15 yrs old and highest incidence was found in white, female patients 15-19 yrs old. Most patients had regional (60%) or localized disease (35%) treated with surgery (98%) and less commonly radiation (38%). Of the surgical patients, subtotal/total thyroidectomy (83%) was the most common procedure performed and 47% had lymph node sampling. The most common histologies were follicular (54%) and medullary (28%) and most tumors were > 2 cm in size (63%). Overall 30 year survival was 91% but higher for females (94%, p=0.02) and for local disease (92%). Disease specific survival was highest for those with no lymph node sampling, and negative lymph nodes. On multivariate analysis only subtotal/total thyroidectomy was an independent prognostic indicator of survival. Neither gender, age, tumor size, histology, nor extent of disease were associated with increased risk of mortality.
Conclusions: The incidence of non-pediatric papillary thyroid cancer is low. Females have a higher incidence but similar survival to males. Subtotal/total thyroidectomy is the only independent prognostic indicator of survival.