Abstract
Simple SummaryThyroid cancer is rare in the pediatric population, but in comparison to thyroid carcinomas in adults, those occurring in children present with aggressive and advanced features. Recent innovations in the surgical technique of robotic thyroidectomy for young patients have offered the opportunity to improve cosmetic effects and oncologic outcomes. The aim of our retrospective study was to conduct a review of the pediatric population who underwent robotic trans-axillary thyroidectomy or conventional open thyroidectomy between February 2008 and December 2019. In the hands of an experienced surgeon, robotic thyroidectomy is a feasible and safe option for pediatric patients.Thyroid cancer in children is very uncommon. For pediatric thyroid cancer, robotic surgery has served as a minimally invasive surgical alternative to conventional open surgery. Our study aimed to evaluate the results of robotic versus open surgical treatment for patients with thyroid cancer younger than 20 years of age at the time of diagnosis. This retrospective review included 161 pediatric patients who underwent robotic transaxillary or conventional open thyroidectomy at our institution from 2008 to 2019. Of these patients, 99 comprised the robotic group and 62 the open group. Patient demographics, surgical outcomes, and disease-free survival rates were compared between the two groups. Patients in the open group were more likely to have advanced stage diseases with a larger tumor size and higher tumor-node-metastasis stage than those in the robotic group. Operation time and follow-up period were similar in both groups. Patients in the robotic group had a lower rate of postoperative complications and a shorter length of hospital stay, but they also had a lower average number of retrieved central lymph nodes. However, there were no significant between group differences in recurrence rates and disease-free survival. In the hands of an experienced surgeon, robotic thyroidectomy is a feasible and safe option for pediatric patients.
Highlights
Thyroid cancer was previously uncommon in the pediatric population
The important clinical, molecular, and pathological differences in differentiated thyroid cancer among children compared to that in adults have prompted the development of unique pediatric guidelines
The extent of surgery ranges from lobectomy to bilateral total thyroidectomy (BTT)
Summary
The incidence of thyroid cancer in children has rapidly continued to increase in the last three decades. Thyroid cancer in advanced stages with local or distant metastasis at the time of diagnosis and recurrence is more common in children than in adults, but the prognosis remains very favorable [1,2,3,4,5,6]. The important clinical, molecular, and pathological differences in differentiated thyroid cancer among children compared to that in adults have prompted the development of unique pediatric guidelines. Surgery is the main approach for treating pediatric thyroid cancer. According to the guideline, owing to the increasing incidence of bilateral and multifocal disease, in the majority of children, BTT with or without central compartment node dissection (CCND) is recommended. Since locoregional or distant metastasis is more likely to be present in young patients, more aggressive treatment is recommended for children than for adults [7,8]
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