Performance of the American Thyroid Association Risk Classification in a Single Center Cohort of Pediatric Patients with Differentiated Thyroid Cancer: A Retrospective Study.

IF 1.7 Q4 ENDOCRINOLOGY & METABOLISM
Journal of Thyroid Research Pub Date : 2019-06-02 eCollection Date: 2019-01-01 DOI:10.1155/2019/5390316
Raad Alwithenani, Sarah DeBrabandere, Irina Rachinsky, S Danielle MacNeil, Mahmoud Badreddine, Stan Van Uum
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引用次数: 6

Abstract

Introduction: Differentiated thyroid cancer (DTC) is the most common endocrine malignancy in children. Retrospective studies show conflicting results regarding predictors of persistent and recurrent disease after initial therapy. In 2015, the American Thyroid Association (ATA) proposed a clinical classification system to identify pediatric thyroid cancer patients at risk for persistent/recurrent disease.

Material and methods: We retrospectively included all patients in our registry diagnosed with papillary DTC at ≤ 18 years of age. We analyzed the prognostic performance of the ATA classification and other risk factors for predicting response to initial treatment and final outcome in pediatric DTC.

Results: We included 41 patients, 34 females and 7 males, diagnosed with papillary DTC at a mean (SD) age of 16.2 (1.8) years. Based on the ATA pediatric risk classification, patients were categorized as low (61%), intermediate (10%), or high risk (29%). The median follow-up period was 7.3 (1-41) years. After initial treatment, disease free status was achieved in 92%, 50%, and 42% of the low, intermediate, and high risk groups, respectively (P <0.01). At the last visit, persistent disease was present in 12%, 25%, and 33% (P=0.27). Assessing other risk factors, only the presence of distant metastases at diagnosis resulted in increased presence of persistent disease at last follow-up (P=0.03).

Conclusion: This study supports the clinical relevance of the ATA risk classification for predicting the response to initial treatment. There was no clear prediction of long-term outcome, but this may be due to limited power caused by the small number of patients.

Abstract Image

Abstract Image

美国甲状腺协会风险分类在分化型甲状腺癌患儿单中心队列中的表现:一项回顾性研究。
分化型甲状腺癌(DTC)是儿童最常见的内分泌恶性肿瘤。回顾性研究显示,关于初始治疗后疾病持续和复发的预测结果相互矛盾。2015年,美国甲状腺协会(ATA)提出了一种临床分类系统,用于识别具有持续/复发疾病风险的儿童甲状腺癌患者。材料和方法:我们回顾性地纳入了所有年龄≤18岁诊断为乳头状DTC的患者。我们分析了ATA分类和其他危险因素的预后表现,以预测儿童DTC对初始治疗和最终结局的反应。结果:我们纳入41例被诊断为乳头状DTC的患者,其中女性34例,男性7例,平均(SD)年龄为16.2(1.8)岁。根据ATA儿科风险分类,患者被分为低(61%)、中(10%)和高风险(29%)。中位随访时间为7.3(1-41)年。初始治疗后,低、中、高风险组患者的无病状态分别为92%、50%和42% (P)。结论:本研究支持ATA风险分类预测初始治疗反应的临床相关性。没有明确的长期预后预测,但这可能是由于患者数量少导致的有限力量。
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来源期刊
Journal of Thyroid Research
Journal of Thyroid Research ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
10
审稿时长
17 weeks
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