Mortality Low but Recurrence High With Thyroid Cancer in Children
A review of the records of 56 children with thyroid carcinoma at Washington University in St. Louis, Missouri, conducted by Dr. Perry W. Grigsby and colleagues, showed an overall survival rate of 98% (one death) but a recurrence rate of 34%.
Patients ranged in age from 4 to 20. Median follow-up was 11 years, but was as long as 30 years in some cases. At the time of diagnosis, 27% of the patients had cancer confined to the thyroid, 60% had lymph node involvement and 13% had lung metastases.
Ten-year progression free survival rate was 61%. None of the children localized disease had a recurrence. The one death that occurred was attributed to a congenital heart defect and not to thyroid carcinoma, Dr. Grigsby's team notes in the August 15th issue of Cancer.
The researchers found that children younger than 15 years of age tended to have more advanced disease at presentation and were more likely to have disease recurrence.
The authors say that "total thyroidectomy and lymph node dissection, followed by postoperative therapy, thyroid hormone (suppressive) administration and diligent surveillance are warranted."
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