Analysis of surgical strategy for pediatric papillary thyroid carcinoma with low-intermediate risk
10.3760/cma.j.cn115330-20220511-00261
- VernacularTitle:低中危儿童甲状腺乳头状癌的手术术式分析
- Author:
Li ZHAO
1
;
Han LI
;
Yuqin HE
;
Kai WANG
;
Jian WANG
;
Dangui YAN
;
Song NI
;
Yiming ZHU
;
Shaoyan LIU
Author Information
1. 国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院北京协和医学院肿瘤医院头颈外科，北京100021
- Keywords:
Thyroid neoplasms;
Carcinoma, papillary;
Pediatric;
Recurrence;
Surgery
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2022;57(12):1396-1402
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility and rationality of lobectomy in the treatment of pediatric thyroid papillary carcinoma (PTC) with low-intermediate risk.Methods:The clinicopathological features and follow-up data of pediatric PTC with low-intermediate risk were reviewed from March 2000 to December 2018 in Cancer Hospital of Chinese Academy of Medical Sciences. The correlations between different surgical procedures and prognoses were evaluated. Propensity score matching(PSM) was used to adjust for risk factors, and the difference in prognoses between the total thyroidectomy (TT) group and the lobectomy (LT) group was compared.Results:A total of 140 patients were included in the study, including 36 males and 104 females. The age range was from 6-year-old to 18-year-old. There were 43 low-risk patients and 97 intermediate-risk patients. The median follow-up time was 87.5 months, ranging from 8 to 241 months, and 20 patients (14.3%) showed recurrence during the follow-up period. Univariate analysis showed that N1b, extrathyroidal extension, the number of lymph node metastasis>5, the ratio of lymph node metastasis≥0.19, and radioactive iodine treatment were risk factors for recurrence (all P value below 0.05), but multivariate analysis showed that only the ratio of lymph node metastasis≥0.19 ( HR=8.69, 95% CI=1.08-70.21, P=0.043) was an independent risk factor for recurrence. There was no significant difference in the 5-year recurrence free survival rates between TT group and LT group before propensity score matching (82.8% vs. 86.5%, χ 2=0.219, P=0.640) and after propensity score matching (89.6% vs. 90.4%, χ 2=0.099, P=0.753). Conclusion:There is no significant difference in recurrence-free survival between TT group and LT group. Lobectomy is feasible for selective pediatric PTC with low-intermediate risk.
