Changing Clinical Presentation of Pediatric Differentiated Thyroid Cancer in Poland: A Retrospective Cohort Study Spanning 45 Years
Authors' conclusion
Our observations of a rising proportion of diagnoses in adolescence, reductions in primary tumor size, and decreased frequency of multifocality and distant metastases may reflect increased detection of patients with less aggressive DTC at earlier disease stages. Nonetheless, we found persistently substantial rates of locoregionally advanced disease features (multifocality, extrathyroidal invasion, and lymph node metastases), which multivariable analyses suggested have significant associations with lateral lymph node and/or distant metastases.
Study context
- Population
- Consecutive juveniles with differentiated thyroid carcinoma (DTC) treated 1970–2015 at Poland's largest pediatric DTC referral center (Gliwice)of 479 patients
- Participants
- 475 participants
- Outcome
- Changes over time in sex, age, histopathological characteristics and DTC stage; independent risk factors for lymph node or distant metastases
Methodological detailssingle-centre, consecutive patients, 1970–2015
- Single-centre
- Consecutive patients
- 1970–2015
Main finding
As reported in the abstract
- Papillary thyroid carcinoma (PTC)
- 88%
- Follicular thyroid carcinoma (FTC)
- 11%
- Tumors ≤2 cm (cases with data)
- 56%
- Tumors >4 cm
- 12%
- Multifocality
- 37%
- Extrathyroidal invasion
- 22%
- Lymph node metastases
- 59%
- Distant metastases
- 16%
- Extrathyroidal invasion during 5-year subperiods after 1990
- 17 to 28%
Observational data: associations, not effects.
Further findings
Risk factors (multivariable analysis)
- Multifocality, extrathyroidal invasion and tumor size independently associated with lateral lymph node metastases
- Multifocality, larger tumor size and N1b metastases independently associated with distant spread
Original publication
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