Clinical analysis of the factors that influence disease progression of differentiated thyroid carcinoma in children.

Abstract

To investigate the factors that influence disease progression of paediatric patients with differentiated thyroid carcinoma. A total of 34 patients under 18 years of age with differentiated thyroid carcinoma (32 papillary and 2 follicular; 9 males and 25 females; 19 cases younger than 15 years old and 15 cases 15-18 years old) treated in our department from June 2009 to August 2015 were retrospectively reviewed. All of the patients underwent a total thyroidectomy or near-total thyroidectomy, central node dissection and/or lateral neck dissection, radioactive iodine treatment and thyroid-stimulating hormone suppressive therapy. A univariate analysis was conducted by log-rank to evaluate the factors that influenced progression-free survival of differentiated thyroid carcinoma in these patients. The median progression-free survival time of all patients was 23 months, ranging from 4 to 72 months. Progression of pulmonary metastatic disease was observed in two cases, a recurrence in the thyroid bed was found in one case, and thyroglobulin significantly increased in four cases. In the univariate analysis, the factor that influenced progression-free survival of differentiated thyroid carcinoma was multifocality (P = 0.040), and independently, age, gender, tumour size, pathological type, degree of infiltration, lymph node metastasis and pulmonary metastasis had no significant influence on progression-free survival (P > 0.05). Multifocality was the factor that influenced the progression-free survival of differentiated thyroid carcinoma patients under 18 years of age.