Long-term survival rates in young patients with thyroid carcinoma.
BACKGROUND
Thyroid carcinoma in patients younger than 18 years is rare. It is associated with a greater risk of metastases. However, the prognosis for these patients is better when compared with that of adults.


OBJECTIVE
To present the experience of a single institution in the treatment of patients with thyroid carcinoma during childhood and adolescence.


METHODS
Thirty-eight patients, ranging in age from 4 to 18 years, were diagnosed as having thyroid carcinoma. Pathologic types of carcinoma included 29 papillary, 4 follicular, 1 Hürthle cell, and 4 medullary cases.


RESULTS
Hypocalcemia was the main complication, being transitory in 9 patients (24%) and permanent in 6 patients (16%). Vocal cord palsy occurred in 2 patients (5%). Two patients (5%) had a surgical site infection. After a mean follow-up of 9.5 years (range, 1-40 years), 28 patients (74%) were alive and had no evidence of disease, 3 (8%) were alive and had recurrent disease, 4 (11%) died (2 of the disease and 2 of non-cancer-related causes), and 3 (8%) were lost to follow-up. The survival rates at 10 years for the patients with papillary, follicular, and medullary carcinoma were 93%, 100%, and 50%, respectively.


CONCLUSIONS
Thyroid carcinoma in patients younger than 18 years has a good prognosis even in the presence of neck or distant metastasis. Total thyroidectomy, associated with adjuvant radioactive iodine therapy and thyroidal suppression or not, is effective in patients with a well-differentiated thyroid carcinoma.
Kowalski
Luiz Paulo
LP
Department of Head and Neck Surgery and Otorhinolaryngology, Centro de Tratamento e Pesquisa Hospital do Câncer A. C. Camargo, São Paulo, Brazil. lp_kowalski@uol.com.br
Gonçalves Filho
João
J
Pinto
Clóvis Antonio Lopes
CA
Carvalho
André Lopes
AL
de Camargo
Beatriz
B
D018263:Adenocarcinoma, Follicular / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D000293:Adolescent; D018276:Carcinoma, Medullary / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D002291:Carcinoma, Papillary / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D016019:Survival Analysis; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D013965:Thyroidectomy