Is multifocality a predictor of poor outcome in childhood and adolescent papillary thyroid carcinoma? Journal Article

   

Authors:	Scholfield, D. W.; Lopez, J.; Eagan, A.; Antal, Z.; Tuttle, R. M.; Ghossein, R.; LaQuaglia, M.; Shaha, A. R.; Shah, J. P.; Wong, R. J.; Patel, S. G.; Ganly, I.
Article Title:	Is multifocality a predictor of poor outcome in childhood and adolescent papillary thyroid carcinoma?
Abstract:	CONTEXT: Total thyroidectomy in pediatric papillary thyroid carcinoma (PTC) is recommended in national guidelines because of the high incidence of multifocal disease (MFD). OBJECTIVE: To determine the incidence of MFD in childhood and adolescent vs adult PTC and whether MFD is a predictor for poorer outcomes in childhood and adolescent PTC. METHODS: We conducted an institutional review board-approved review of patients with PTC undergoing surgery (1986-2021) at Memorial Sloan Kettering Cancer Center. Clinical and pathological characteristics in patients with unifocal disease (UFD) and MFD were compared using Pearson's χ2 test. Survival outcomes were analyzed using the Kaplan-Meier method and log-rank test. Multivariate analysis assessed the impact of MFD on outcome. RESULTS: MFD was less common in childhood and adolescent patients with PTC (45%; 127/283) than in adults (54%; 3023/5564; P = .002). Childhood and adolescent patients with UFD and MFD had similar tumor stage and PTC subtype at presentation, with no significant difference in histopathologic features. Median follow-up was 68 months. There was no significant difference in 5-year recurrence-free probability and overall survival was 100% in both groups. There was no significant difference in 5-year contralateral lobe PTC-free probability between patients with UFD and MFD treated with lobectomy. Multivariate analysis showed MFD was not a predictor for recurrence. CONCLUSION: MFD was less common in childhood and adolescent patients with PTC than adults and was not a predictor of poor outcome on multivariate analysis, with excellent long-term outcomes in all patients with PTC. MFD does not appear to warrant completion thyroidectomy in childhood and adolescent patients selected for lobectomy. © The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
Keywords:	adolescent; adult; child; retrospective studies; neoplasm recurrence, local; risk factors; pathology; retrospective study; risk factor; tumor recurrence; thyroidectomy; thyroid neoplasms; thyroid papillary carcinoma; thyroid tumor; procedures; papillary thyroid carcinoma; multifocality; humans; human; thyroid cancer, papillary; pediatric thyroid carcinoma
Journal Title:	Journal of Clinical Endocrinology and Metabolism
Volume:	108
Issue:	12
ISSN:	0021-972X
Publisher:	Oxford University Press
Date Published:	2023-12-01
Start Page:	3135
End Page:	3144
Language:	English
DOI:	10.1210/clinem/dgad369
PUBMED:	37350510
PROVIDER:	scopus
PMCID:	PMC10655537
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85177103369&doi=10.1210%2fclinem%2fdgad369&partnerID=40&md5=ef3b5c326846d173fa73dd3efda38c8c
Notes:	Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Ian Ganly -- Source: Scopus

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