Multivariate analysis of prognostic factors for differentiated thyroid carcinoma in children

被引:0
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作者
Barbara Jarząb
Daria Handkiewicz Junak
Jan Włoch
Barbara Kalemba
Józef Roskosz
Aleksandra Kukulska
Zbigniew Puch
机构
[1] Department of Nuclear Medicine and Endocrine Oncology,
[2] Centre of Oncology,undefined
[3] Maria Skłodowska – Curie Memorial Institute,undefined
[4] Gliwice,undefined
[5] Poland,undefined
[6] Department of Surgery,undefined
[7] Centre of Oncology,undefined
[8] Maria Skłodowska – Curie Memorial Institute,undefined
[9] Gliwice,undefined
[10] Poland,undefined
来源
European Journal of Nuclear Medicine | 2000年 / 27卷
关键词
Key words: Thyroid cancer; Children; Extent of surgery; Radioiodine treatment;
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摘要
At most centres, the standard treatment for differentiated thyroid cancer (DTC) comprises total thyroidectomy, radioiodine treatment and thyroid-stimulating hormone (TSH) suppressive therapy. There is, however, considerable disagreement over the appropriate treatment for DTC in children. Some dispute the use of total thyroidectomy and/or question the routine application of iodine-131 therapy in children. The aim of this study was to perform a retrospective analysis of treatment results and prognostic factors for DTC in children treated at our centre. The study included 109 children with DTC (aged 6–17 years). The primary treatment comprised total thyroidectomy in 81 cases, radioiodine therapy in 85 cases and TSH suppressive therapy with l-thyroxine in all patients. Uni- and multivariate analysis of prognostic factors for disease-free survival was performed using the Cox regression method. The actuarial survival rate was 100%, and the 5- and 10-year actuarial disease-free survival rates were 80% and 61% respectively. Univariate analysis revealed that older age, total thyroidectomy and radioiodine treatment had a positive impact on disease-free survival whereas there were no statistical differences with regard to the child’s sex, histological type of cancer or lymph node status. On multivariate analysis, radical surgery was estimated to be the most significant factor (P=0.007) for disease-free survival, while less than total thyroidectomy increased the relative risk of relapse by a factor of 10. Radioiodine treatment decreased the relative risk of relapse by a factor of 5, but with borderline significance (P=0.07). Permanent postoperative complications were observed in 17% of children: in 11 laryngeal palsy occurred, in six there was hypoparathyroidism, and one suffered from both. It is concluded that total thyroidectomy and radioiodine treatment significantly improve recurrence-free survival in children and should be routinely applied even in young children as the primary treatment of DTC.
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页码:833 / 841
页数:8
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