ETA2023 Poster Presentations Thyroid Cancer clinical 3 (9 abstracts)
Changes in clinical presentation of paediatric differentiated thyroid cancer (DTC) treated in one centre over 40 years
Aleksandra Kropinska 1 , Aleksandra Ledwon 1 , Ewa Paliczka Cieslik 1 , Tomasz Olczyk 1 , Aleksandra Blewąska 1 , Marcela Krzempek 2 , Agata Wilk 2 , Alexander Cortez 2 , Agnieszka Czarniecka 3 , Barbara Jarzab 1 & Daria Handkiewicz Junak 1
1Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Department of Nuclear Medicine and Endocrine Oncology, Gliwice, Poland; 2Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Department of Biostatistics and Bioinformatics, Gliwice, Poland; 3Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Department of Oncological and Reconstructive Surgery, Gliwice, Poland
Background: Differentiated thyroid carcinoma (DTC) in children is a rare cancer, occurring in 1/100,000 children/year. In the adults a steady increase in the incidence and change in presentation of DTC has been observed over the past 30 years.
Purpose: Evaluation of changes in the clinical presentation of paediatric DTC on the example of children treated in Institute of Oncology in Gliwice between 1970 and 2015.
Material and methods: Retrospective analysis of 475 patients with DTC diagnosed ≤18 years of age.
Results: Half of the children were >15 years, 9.9% were under 10 years of age at the time of diagnosis. The girls: boys ratio was 2.7. Median follow-up time was 11 years (0.1- 47.8 years), 2% of patients were lost to follow-up. PTC was diagnosed in 88%, FTC in 11%, and poorly-differentiated carcinoma in 1%. Primary tumor size could be determined in 70% of children. 56% of tumors were less than 2 cm, 12.3% >4 cm. Multifocality was found in 34%, extrathyroidal invasion in 20%. Lymph node metastasis occurred in 59% of patients. Distant metastases were found in 76 patients (16%). Analysis revealed increasing DTC incidence among adolescents (>15 years of age) and decreasing incidence of FTC compared to PTC. There was an increase of small tumors ≤2 cm and a decrease of multifocality, particularly for tumors ≤1 cm. Extrathyroidal invasion was stable over time and correlated with tumor size. There was a significant increase in the rate of central neck node metastases. The percentage of distant metastases decreased significantly. Prognostic factors for distant metastasis were tumor size, multifocality, and lateral neck node metastasis.
Conclusions: We can expect an increasing incidence of pediatric DTC, diagnosed at an earlier stage than in years when USG were not widely available. Despite the increasing number of small, monofocal papillary carcinomas in children, the frequency of carcinomas >3-4 cm is not decreasing, multifocal carcinomas still affect every fourth patient and extrathyroidal invasion every fifth. The increased frequency of metastases to the central neck lymph nodes probably results from their increased detectability and does not increase the risk of distant metastases. The incidence of distant metastases in the study group was highest between 1996 and 2000 (30%), which may be due to a selection bias, and then gradually decreased to about 10%. Risk factors for distant metastasis were larger tumor, multifocality and lateral neck nodes metastases.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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