title: Tumor size and extent of disease at diagnosis predict the response to initial therapy for papillary thyroid carcinoma in children and adolescents.
abstract: Treatment of papillary thyroid carcinoma (PTC) in children and adolescents is controversial. We previously showed that large tumor size, multifocal disease, and extensive disease at diagnosis predict recurrence. We examined 47 patients with PTC to determine whether these features predict response to treatment. Overall, 70% of the patients (33/47) remitted with initial treatment. 79% (15/19), of Class I, 86% (12/14) of Class II, and 100% (6/6) of Class III, but none of Class IV patients (n = 8) (p < 0.001) achieved remission. Tumor size for patients who entered remission (2.0 +/- 0.2 cm) was less than for patients with persistent disease (4.2 +/- 0.4) (p < 0.0005). Extent of disease at diagnosis correlated with the number of radioactive iodine (RAI) treatments (p = 0.022) and dose (p = 0.002) required to achieve first remission. We conclude that extensive disease at diagnosis and larger tumor size predict failure to remit after initial treatment of PTC in children and adolescents.
authors.affiliation: Department of Pediatrics, Walter Reed Army Medical Center, Washington, DC 20307, USA. patricia.powers@na.amedd.army.mil
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Powers
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Dinauer
authors.forename: R Michael
authors.initials: RM
authors.lastname: Tuttle
authors.forename: Daniel K
authors.initials: DK
authors.lastname: Robie
authors.forename: Donald R
authors.initials: DR
authors.lastname: McClellan
authors.forename: Gary L
authors.initials: GL
authors.lastname: Francis
mesh_terms: D000293:Adolescent; D000328:Adult; D002291:Carcinoma, Papillary / Q000453:epidemiology / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology*; D011237:Predictive Value of Tests; D012074:Remission Induction; D013964:Thyroid Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D013965:Thyroidectomy; D016896:Treatment Outcome