title: Conservative or radical surgery for pediatric papillary thyroid carcinoma: A systematic review of the literature.
abstract: BACKGROUND
  Pediatric papillary thyroid carcinoma (PTC) is characterized by an aggressive clinical course. Early diagnosis is a challenge and treatment consists principally of partial or total thyroidectomy±neck dissection and radioactive iodine therapy. Due to the rarity of PTC in children, there is no consensus on optimal surgical treatment.
  
  
  RESULTS
  A literature search was carried out using PubMed, Embase, Medline, Cochrane and Web of Science. Seven studies (489 patients) investigating the outcome of surgically managed pediatric PTC were identified. No clear advantage in survival or recurrence rate was found for total thyroidectomy compared to other surgical approaches.
  
  
  CONCLUSIONS
  Despite the aggressive behavior of PTC, prognosis is good, with low mortality. After removal of disease and prevention of recurrence, reduction of iatrogenic complications are a priority in this age group. Due to the paucity of available evidence, this review cannot recommend conservative or radical surgery for pediatric papillary thyroid carcinoma. To answer this question, we recommend the establishment of a randomized controlled trial with adequately matched baseline variables.
authors: Department of Otolaryngology, Head and Neck Surgery, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
authors: Xi
authors: X
authors: Jin
authors: Department of Otolaryngology, Head and Neck Surgery, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK. Electronic address: lmm398@doctors.org.uk.
authors: Liam
authors: L
authors: Masterson
authors: Department of Otolaryngology, Head and Neck Surgery, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
authors: Anant
authors: A
authors: Patel
authors: Department of Pathology, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
authors: Liz
authors: L
authors: Hook
authors: Department of Pediatric Oncology, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
authors: James
authors: J
authors: Nicholson
authors: Department of Clinical Oncology, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
authors: Sarah
authors: S
authors: Jefferies
authors: Department of Oncology, University College Hospital, London NW1 2PG, UK.
authors: Mark
authors: M
authors: Gaze
authors: Department of Head & Neck Oncology, Norfolk & Norwich University Hospital, Norwich NR4 7UY, UK.
authors: Ramez
authors: R
authors: Nassif
authors: US Air Force and Army Voice Center, San Antonio, TX, USA.
authors: Robert
authors: R
authors: Eller
authors: Department of Paediatric Endocrinology, Guy's & St Thomas' Hospital, London SE1 7UH, UK.
authors: Tony
authors: T
authors: Hulse
authors: Department of Otolaryngology, Head and Neck Surgery, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK.
authors: Piyush
authors: P
authors: Jani
mesh_terms: D000293:Adolescent; D002277:Carcinoma / Q000601:surgery*; D002291:Carcinoma, Papillary; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D037981:Neck Dissection / Q000379:methods*; D011379:Prognosis; D012008:Recurrence; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*
keywords: Genetic markers; Papillary thyroid carcinoma; Pediatric; Radioactive iodine; Surgery