open access

Vol 70, No 4 (2019)
REVIEWS — Postgraduate Education
Published online: 2019-08-14
Submitted: 2018-11-26
Accepted: 2018-12-10
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Surgical approach to differentiated thyroid cancers (DTC) in children [Specyfika leczenia chirurgicznego zróżnicowanych raków tarczycy (ZRT) u dzieci]

Agnieszka Czarniecka, Grzegorz Woźniak, Aleksandra Kropińska, Barbara Jarząb, Daria Handkiewicz-Junak
DOI: 10.5603/EP.a2019.0033
·
Pubmed: 31489960
·
Endokrynologia Polska 2019;70(4):357-366.

open access

Vol 70, No 4 (2019)
REVIEWS — Postgraduate Education
Published online: 2019-08-14
Submitted: 2018-11-26
Accepted: 2018-12-10

Abstract

Thyroid cancer in children is rare and accounts for 1–3% of all malignant tumours. Differentiated thyroid cancers (DTC) and particularly papillary thyroid carcinoma (PTC) (90% of cases) are the most prevalent. Surgery is the mainstay of treatment in patients with DTC. The current recommendations are based not on prospective randomised clinical trials, but on retrospective trials and expert opinions. Therefore, it is not easy to choose the optimal therapeutic strategy to obtain the best treatment and to avoid serious complications and adverse events. In children and adolescents, the clinical presentation, course, and prognosis are different from those seen in adults. Children are generally at low risk of death but at higher risk of long-term harm due to overly aggressive treatment. Therefore, optimisation of the therapeutic strategy is particularly important. The present paper provides a summary of the current guidelines on surgical management in thyroid tumours and DTC in children and adolescents. 

Abstract

Thyroid cancer in children is rare and accounts for 1–3% of all malignant tumours. Differentiated thyroid cancers (DTC) and particularly papillary thyroid carcinoma (PTC) (90% of cases) are the most prevalent. Surgery is the mainstay of treatment in patients with DTC. The current recommendations are based not on prospective randomised clinical trials, but on retrospective trials and expert opinions. Therefore, it is not easy to choose the optimal therapeutic strategy to obtain the best treatment and to avoid serious complications and adverse events. In children and adolescents, the clinical presentation, course, and prognosis are different from those seen in adults. Children are generally at low risk of death but at higher risk of long-term harm due to overly aggressive treatment. Therefore, optimisation of the therapeutic strategy is particularly important. The present paper provides a summary of the current guidelines on surgical management in thyroid tumours and DTC in children and adolescents. 
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Keywords

differentiated thyroid cancer; children, surgery

About this article
Title

Surgical approach to differentiated thyroid cancers (DTC) in children [Specyfika leczenia chirurgicznego zróżnicowanych raków tarczycy (ZRT) u dzieci]

Journal

Endokrynologia Polska

Issue

Vol 70, No 4 (2019)

Pages

357-366

Published online

2019-08-14

DOI

10.5603/EP.a2019.0033

Pubmed

31489960

Bibliographic record

Endokrynologia Polska 2019;70(4):357-366.

Keywords

differentiated thyroid cancer
children
surgery

Authors

Agnieszka Czarniecka
Grzegorz Woźniak
Aleksandra Kropińska
Barbara Jarząb
Daria Handkiewicz-Junak

References (29)
  1. Karapanou O, Tzanela M, Vlassopoulou B, et al. Differentiated thyroid cancer in childhood: a literature update. Hormones (Athens). 2017; 16(4): 381–387.
  2. Francis GL, Waguespack SG, Bauer AJ, et al. American Thyroid Association Guidelines Task Force. Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer. Thyroid. 2015; 25(7): 716–759.
  3. Chan CM, Young J, Prager J, et al. Pediatric thyroid cancer. Adv Pediatr. 2017; 64(1): 171–190.
  4. Verburg FA, Van Santen HM, Luster M. Pediatric papillary thyroid cancer: current management challenges. Onco Targets Ther. 2017; 10: 165–175.
  5. Niedziela M, Handkiewicz-Junak D, Małecka-Tendera E, et al. Diagnostics and treatment of differentiated thyroid carcinoma in children - Guidelines of Polish National Societies. Endokrynol Pol. 2016; 67(6): 628–642.
  6. Hay ID, Johnson TR, Kaggal S, et al. Papillary thyroid carcinoma (PTC) in children and adults: comparison of initial presentation and long-term postoperative outcome in 4432 patients consecutively treated at the Mayo Clinic during eight decades (1936–2015). World J Surg. 2018; 42(2): 329–342.
  7. Gupta A, Ly S, Castroneves LA, et al. A standardized assessment of thyroid nodules in children confirms higher cancer prevalence than in adults. J Clin Endocrinol Metab. 2013; 98(8): 3238–3245.
  8. Niedziela M. Pathogenesis, diagnosis and management of thyroid nodules in children. Endocr Relat Cancer. 2006; 13(2): 427–453.
  9. Monaco SE, Pantanowitz L, Khalbuss WE, et al. Cytomorphological and molecular genetic findings in pediatric thyroid fine-needle aspiration. Cancer Cytopathol. 2012; 120(5): 342–350.
  10. Smith M, Pantanowitz L, Khalbuss WE, et al. Indeterminate pediatric thyroid fine needle aspirations: a study of 68 cases. Acta Cytol. 2013; 57(4): 341–348.
  11. Cooper DS, Doherty GM, Haugen BR, et al. American Thyroid Association (ATA) Guidelines Taskforce on Thyroid Nodules and Differentiated Thyroid Cancer. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009; 19(11): 1167–1214.
  12. Jarząb B, Dedecjus M, Słowińska-Klęcka D, et al. uidelines of Polish National Societies Diagnostics and Treatment of Thyroid Carcinoma. 2018 Update. Endokrynol Pol . 2018; 69(1): 34–74.
  13. Farahati J, Parlowsky T, Mäder U, et al. Differentiated thyroid cancer in children and adolescents. Langenbecks Arch Surg. 1998; 383(3-4): 235–239.
  14. Hay ID, Gonzalez-Losada T, Reinalda MS, et al. Long-term outcome in 215 children and adolescents with papillary thyroid cancer treated during 1940 through 2008. World J Surg. 2010; 34(6): 1192–1202.
  15. Carty SE, Cooper DS, Doherty GM, et al. American Thyroid Association Surgery Working Group, American Association of Endocrine Surgeons, American Academy of Otolaryngology — Head and Neck Surgery, American Head and Neck Society. Consensus statement on the terminology and classification of central neck dissection for thyroid cancer. Thyroid. 2009; 19(11): 1153–1158.
  16. Savio R, Gosnell J, Palazzo FF, et al. The role of a more extensive surgical approach in the initial multimodality management of papillary thyroid cancer in children. J Pediatr Surg. 2005; 40(11): 1696–1700.
  17. Machens A, Lorenz K, Nguyen Thanh P, et al. Papillary thyroid cancer in children and adolescents does not differ in growth pattern and metastatic behavior. J Pediatr. 2010; 157(4): 648–652.
  18. Cooper DS, Tufano RP. Prophylactic central neck dissection in differentiated thyroid cancer: a procedure in search of an indication. Thyroid. 2012; 22(4): 341–343.
  19. Shen WT, Ogawa L, Suh I, et al. Central neck lymph node dissection for papillary thyroid cancer: the reliability of surgeon judgment in predicting which patients will benefit. Surgery. 2010; 148 (2): 398–403.
  20. Carling T, Carty SE, Ciarleglio MM, et al. American Thyroid Association Surgical Affairs Committee. American Thyroid Association design and feasibility of a prospective randomized controlled trial of prophylactic central lymph node dissection for papillary thyroid carcinoma. Thyroid. 2012; 22(3): 237–244.
  21. Cracchiolo JR, Wong RJ. Management of the lateral neck in well differentiated thyroid cancer. Eur J Surg Oncol. 2018; 44(3): 332–337.
  22. Handkiewicz-Junak D, Wloch J, Roskosz J, et al. Total thyroidectomy and adjuvant radioiodine treatment independently decrease locoregional recurrence risk in childhood and adolescent differentiated thyroid cancer. J Nucl Med. 2007; 48(6): 879–888.
  23. Palaniappan R, Krishnamurthy A, Rajaraman SS, et al. Management outcomes of pediatric and adolescent papillary thyroid cancers with a brief review of literature. Indian J Cancer. 2018; 55(1): 105–110.
  24. Angelos P. Ethical and medicolegal issues in neuromonitoring during thyroid and parathyroid surgery: a review of the recent literature. Curr Opin Oncol. 2012; 24(1): 16–21.
  25. Calò PG, Medas F, Conzo G, et al. Intraoperative neuromonitoring in thyroid surgery: Is the two-staged thyroidectomy justified? Int J Surg. 2017; 41 (Suppl 1): S13–S20.
  26. Barczyński M, Cichoń S, Konturek A, et al. Applicability of intraoperative parathyroid hormone assay during total thyroidectomy as a guide for the surgeon to selective parathyroid tissue autotransplantation. World J Surg. 2008; 32(5): 822–828.
  27. Skinner MA, Norton JA, Moley JF, et al. Heterotopic autotransplantation of parathyroid tissue in children undergoing total thyroidectomy. J Pediatr Surg. 1997; 32(3): 510–513.
  28. Tuggle CT, Roman SA, Wang TS, et al. Pediatric endocrine surgery: who is operating on our children? Surgery. 2008; 144(6): 869–77; discussion 877.
  29. Kundel A, Thompson GB, Richards ML, et al. Pediatric endocrine surgery: a 20-year experience at the Mayo Clinic. J Clin Endocrinol Metab. 2014; 99(2): 399–406.

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