87
th Annual Meeting of the American Thyroid Association.

Abstract

Poster #281 from Abstracts of the 87th Annual Meeting of the American Thyroid Association

Papillary thyroid carcinoma (PTC) accounts for 90% of childhood
thyroid cancer cases. Proper risk classification of children with PTC
is important to optimize treatment and avoid long-term side effects.
In 2015, the American Thyroid Association (ATA) published
guidelines for the management of children with PTC. Data from the
Surveillance, Epidemiology, and End Results (SEER) populationbased
program were used to describe the characteristics and outcomes
of children and adolescents with PTC who were classified as
low-risk per the ATA guidelines. Using SEER 18, we analyzed patients
less than 20 years of age diagnosed with PTC between 2004
and 2014. TNM staging was used to categorize patients into the ATA
pediatric low-risk group, which was defined as T1, T2, T3, or Tx with
N0, Nx, or N1a in situ, and no distant metastases. Of 1861 patients
with PTC, 887 (48%) were classified as low-risk. Of these, 748 (84%)
were female, and 717 (81%) were between 15 and 19 years of age at
diagnosis. Sixty-one percent of patients were non-Hispanic White,
23% were Hispanic, and 6% were non-Hispanic Black. Of the 875
patients who had surgery, 81% underwent a total thyroidectomy and
11% had a lobectomy and/or isthmectomy. A total of 409 (46%)
patients received irradiation. Eight patients (0.9%) developed a
second malignancy. Six patients (0.6%) died from causes other than
their thyroid malignancy. The 5-year disease-specific survival was
100%. Pediatric and adolescent patients with low-risk PTC per ATA
classification have an excellent prognosis. A major limitation of this
study is the lack of recurrence data in the SEER registry. Nonetheless,
favorable outcomes support minimizing therapy for low-risk
patients. Prospective studies are warranted to assess radiation
avoidance and subsequent outcomes in this group.