Thyroid cancer in children: management and outcome experience of a referral center.
OBJECTIVE
To shed light on the discrepancy between the advanced stage at presentation and high recurrence rate of well-differentiated thyroid cancer in children and the overall good survival.


METHODS
The files of 75 children with well-differentiated thyroid cancer treated from 1954 to 2001 in a major tertiary-care hospital were reviewed for disease course, management, and outcome.


RESULTS
Sixty patients (80%) had positive neck metastases with involvement of central compartment lymph nodes in all, lateral neck nodes in 36, and distant metastases in 4. Sixty-seven patients underwent total thyroidectomy with adjuvant radioiodine treatment and 8 underwent hemithyroidectomy; all had concomitant neck treatment. The rate of local (5%) and neck (9%) recurrence was similar to the total rate reported in adults. Total thyroidectomy led to a significantly lower recurrence rate (7.5%) than hemithyroidectomy (38%; P < 0.005). Type of neck dissection did not affect recurrence or appearance of distant metastases. All deaths (n = 2) were due to distant metastases, whereas 30% of adult deaths are due to local or neck disease.


CONCLUSIONS
The treatment of choice for well-differentiated thyroid cancer in young patients is total thyroidectomy. Neither regional disease at presentation nor recurrences affect survival.
Popovtzer
Aron
A
Department of Otolaryngology-Head and Neck Surgery, Rabin Medical Center, Beilinson Campus, Petah Tiqva, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. aronpopovtzer@yahoo.com
Shpitzer
Thomas
T
Bahar
Gideon
G
Feinmesser
Raphael
R
Segal
Karol
K
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012017:Referral and Consultation; D013964:Thyroid Neoplasms / Q000601:surgery*; D016896:Treatment Outcome