Mexican Study Focuses on Clinical Management of Pediatric Thyroid Cancer
Posted: Wednesday, July 1, 2020
A retrospective study performed by Isabel B. Galán, MD, and colleagues of the National Institute of Pediatrics in Mexico City, characterized the clinical presentations of pediatric thyroid cancer as well as the risks of surgical interventions. With papillary cancer being the most common type in pediatric patients and nearly 70% of metastases found in the lymph nodes, the investigators focused on risk factors for metastases, such as a postoperative positive thyroglobulin parameter. The study findings were slated for presentation at the ENDO 2020 meeting (Abstract MON-092) and published in the Journal of the Endocrine Society.
The study enrolled a total of 43 patients, 69.8% of whom were female, from January 2010 through May 2019. The average age of the participants was 12, with a range of 5 to 17. Metastases were found in 69.8% of patients, 46.5% of which were in the lymph nodes, 2.3% of which were pulmonary, and 23.3% of which were in both; 16.3% of patients lacked data, and 11.6% lacked metastases. Other histopathologic findings focused on the diagnostic site: 86% were papillary, 11.6% were medullary, and 2.3% were follicular.
Surgical treatment included total thyroidectomy with lymph node emptying (74% of patients), thyroidectomy alone (16.3%), modified radical neck dissection (5%), and hemithyroidectomy (4.7%). A second surgery was needed in 16% of the patients after histopathologic findings. An average dose of 200 mCi (with a range of 100–720 mCi) of iodine treatment was given to 29 patients.
The main postoperative complication was an increased risk of hypoparathyroidism. A postoperative positive thyroglobulin level (odds ratio = 1.42, range 1.1–1.6) was found to indicate the risk of metastases or complications. Hypoparathyroidism was observed in 27 patients and was permanent in 16. Hypoparathyroidism was linked to a parathyroid hormone less than 10 pg/mL, serum calcium levels less than 8 mg/mL, and postsurgical ionized calcium levels less than 4 mg/dL.
Disclosure: The study authors reported no conflicts of interest.