The overall survival for the entire group was 153.8 months, limited to 155 months of maximum follow-up. Papillary carcinomas (mean survival, 155.3 months) fared better than follicular carcinomas Patient age, presence of positive cervical nodes, extent of surgery, and use of radioactive iodine therapy did not significantly influence overall survival. The male gender, follicular histology, and initial local disease invasion had the most significant effects on decreasing long-term survival.
The results concur with the findings from other studies that state that pediatric thyroid cancer presents most commonly in the teenage years, and primarily in females. The most common histologic type is papillary, as is seen in the adult population. The distribution of nodal disease (37.1 percent) was also similar to that seen in prior studies. This research revealed that whereas treatment of the primary tumor ranged from simple lobectomy to total thyroidectomy, the extent of surgical intervention did not influence survival outcomes. This finding differs from several prior reports that describe superior outcomes in patients undergoing more radical resection such as sub-total or total thyroidectomy. Age at diagnosis, nodal status, and the addition of radioactive iodine therapy also had no significant influence on survival. Male gender, primary disease site extension, and follicular subtype all had negative prognostic influence on survival compared to other disease site variables. Conclusions: Pediatric thyroid carcinoma exhibits excellent long-term survival outcomes.
Patients with follicular variants demonstrate somewhat poorer outcomes than those with papillary variants. Although this disease is much more common in females than males, males with thyroid carcinoma have poorer outcomes than females. Locally advanced primary disease site extension also carries a poorer prognosis compared to intrathyroidal disease alone. While diagnostic work-up and management must be focused for each patient, accounting for potential short-and long-term morbidities, this new research offers current reference survival information for patients with pediatric thyroid carcinoma with respect to survival and clinical factors affecting outcome.
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