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Thyroid Cancer In Children: A Multicenter International Study Highlighting Clinical Features And Surgical Outcomes Of Primary And Secondary Tumors
  • +22
  • Cristina Martucci,
  • Alessandro Crocoli,
  • Maria Debora De Pasquale,
  • Claudio Spinelli,
  • Silvia Strambi,
  • Paolo Brazzarola,
  • Eleonora Morelli,
  • Jessica Cassiani,
  • JULIANA MANCERA,
  • Juan Luengas,
  • Pablo Lobos ,
  • Daniel Liberto,
  • Estefanìa Astori,
  • Sabine Sarnacki,
  • Vincent Couloigner,
  • François Simon,
  • Cassandre Lambert,
  • Simone Abib,
  • Onivaldo Cervantes,
  • Eliana Caran,
  • Diana Delgado Lindman,
  • Matthew Jones,
  • Rajeev Shukla,
  • Paul Losty,
  • Alessandro Inserra
Cristina Martucci
Bambino Gesù Children's Hospital - IRCCS

Corresponding Author:[email protected]

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Alessandro Crocoli
Bambino Gesù Children's Hospital - IRCCS
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Maria Debora De Pasquale
Bambino Gesù Children's Hospital - IRCCS
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Claudio Spinelli
University of Pisa
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Silvia Strambi
University of Pisa
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Paolo Brazzarola
University and Hospital Trust of Verona
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Eleonora Morelli
University and Hospital Trust of Verona
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Jessica Cassiani
University of Verona
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JULIANA MANCERA
Hospital Militar Central
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Juan Luengas
Hospital Militar Central
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Pablo Lobos
Hospital Italiano de Buenos Aires
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Daniel Liberto
Hospital Italiano de Buenos Aires
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Estefanìa Astori
Hospital Italiano de Buenos Aires
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Sabine Sarnacki
Hopital Necker-Enfants Malades
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Vincent Couloigner
Hopital universitaire Necker-Enfants malades
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François Simon
Hopital universitaire Necker-Enfants malades
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Cassandre Lambert
Hopital universitaire Necker-Enfants malades
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Simone Abib
Pediatric Oncology Institute - GRAACC - Federal University of São Paulo
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Onivaldo Cervantes
Federal University of São Paulo
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Eliana Caran
Pediatric Oncology Institute - GRAACC - Federal University of São Paulo
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Diana Delgado Lindman
Pediatric Oncology Institute - GRAACC - Federal University of São Paulo
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Matthew Jones
Alder Hey Children's NHS Foundation Trust
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Rajeev Shukla
Alder Hey Children's NHS Foundation Trust
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Paul Losty
Alder Hey Children's NHS Foundation Trust
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Alessandro Inserra
Bambino Gesù Pediatric Hospital - IRCCS, Rome
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Abstract

Background: Thyroid gland malignancy is rare in pediatrics (0.7% of tumors); only 1.8% are observed in patients < 20 yrs with a higher prevalence recorded in females and adolescents. Risk factors include genetic syndromes - MEN disorders, autoimmune disease and ionizing radiation exposure. Radiotherapy is also linked with increased risk of secondary thyroid cancers. The present study describes the clinical features and surgical outcomes of primary and secondary thyroid tumors. Methods: Institutional data was collected on pediatric patients with thyroid cancer during 2000 - 2020 from 8 International Surgical Oncology centers. Statistical analysis was performed using GraphPad Prism. Results: Of 255 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] 0.7466-5.132, p 0.2323), had bilateral glandular location (OR 2.847, 95% CI 0.6835-12.68, p 0.2648) and proved metastatic at 1st diagnosis (OR 1.259, 95% CI 0.3267-5.696 p>0.999). Secondary tumors showed a higher incidence of disease relapse (OR 1.556, 95% CI 0.4579-5.57, p 0.4525) and surgical morbidity (OR 2.042, 95% CI 0.7917-5.221, p 0.1614) including hypoparathyroidism and recurrent laryngeal nerve injury. Overall survival (OS) was 99% at 1 year and 97% after 10 years. No EFS differences were evident with primary vs. secondary tumors (Chi square 0.7307, p 0.39026). Conclusions: This multicenter study demonstrates excellent survival for pediatric thyroid malignancy. Secondary tumors exhibit greater disease relapse (15.8% vs 10.5%) and a higher incidence of surgical related complications (36.8% vs 22.2%).
22 Jul 2022Published in Frontiers in Pediatrics volume 10. 10.3389/fped.2022.914942