Trends and predictors of positive surgical margins in pediatric thyroid cancer

IF 1.2 4区医学 Q3 OTORHINOLARYNGOLOGY

International journal of pediatric otorhinolaryngology Pub Date : 2025-03-27 DOI:10.1016/j.ijporl.2025.112328

John J. Ceremsak , Rahul K. Sharma , Vivian L. Weiss , Huiying Wang , Michael C. Topf , Sarah L. Rohde , Ryan H. Belcher

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引用次数: 0

Abstract

Objective

To understand trends in positive margin rates in pediatric thyroid cancer over time and investigate predictors of positive margins.

Study design and setting

Retrospective analysis of deidentified National Cancer Database (NCDB) records from 2004 to 2020.

Methods

The study cohort included pediatric patients (age 18 or younger) with thyroid cancer with available records in the NCDB. The positive margin rate was calculated by year of diagnosis. Multivariable regression was used to assess for predictors of positive margins. Survival analysis was performed stratified by margin status.

Results

We identified 6240 patients who met inclusion criteria. The overall positive margin rate was 15.5 % and did not change significantly over the study period. Positive margins were independently associated with younger age, male gender, total thyroidectomy, papillary histology, and positive lymph node status on multivariable logistic regression models. Hospital volume was not a predictor of positive margin rate. Margin status did not impact overall survival.

Conclusion

Positive margins in pediatric thyroid cancer are more likely in younger patients, male patients, those undergoing total thyroidectomy, those with lymph node metastasis, and those with papillary thyroid carcinoma. Hospital volume is not associated with positive margin rate. Positive margins do not impact overall survival in this patient population.

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儿童甲状腺癌手术切缘阳性的趋势和预测因素

目的了解儿童甲状腺癌切缘阳性率随时间的变化趋势，探讨切缘阳性率的预测因素。研究设计和设置：对2004年至2020年未确定的国家癌症数据库（NCDB）记录进行回顾性分析。方法研究队列包括NCDB中有记录的18岁或以下甲状腺癌患儿。阳性切缘率按诊断年份计算。采用多变量回归评估正边际的预测因子。生存分析按切缘状况分层进行。结果6240例患者符合纳入标准。总体正利润率为15.5%，在研究期间没有显著变化。在多变量logistic回归模型中，切缘阳性与年龄、男性、甲状腺全切除术、乳头状组织学和淋巴结阳性状态独立相关。医院容量不是阳性边际率的预测因子。边缘状态不影响总生存率。结论儿童甲状腺癌边缘阳性多见于年轻、男性、甲状腺全切除术患者、淋巴结转移患者和甲状腺乳头状癌患者。医院容量与正边际率无关。阳性切缘不影响该患者群体的总生存率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of pediatric otorhinolaryngology 医学-耳鼻喉科学

CiteScore

3.20

自引率

6.70%

发文量

276

审稿时长

62 days

期刊介绍： The purpose of the International Journal of Pediatric Otorhinolaryngology is to concentrate and disseminate information concerning prevention, cure and care of otorhinolaryngological disorders in infants and children due to developmental, degenerative, infectious, neoplastic, traumatic, social, psychiatric and economic causes. The Journal provides a medium for clinical and basic contributions in all of the areas of pediatric otorhinolaryngology. This includes medical and surgical otology, bronchoesophagology, laryngology, rhinology, diseases of the head and neck, and disorders of communication, including voice, speech and language disorders.