Dynamic Risk Stratification for Predicting Long-term Outcomes in Pediatric Differentiated Thyroid Cancers
Authors' conclusion
Like adults, DRS correctly predicts long-term outcomes in pediatric DTC. In addition to ATA initial risk stratification, DRS could further refine risk in pediatric DTCs and help in planning more personalized treatment and follow-up strategies.
Study context
- Population
- Children (age ≤18 years) with DTC and follow-up ≥5 years; all had thyroidectomy and radioiodine; median age at diagnosis 15 years
- Participants
- 176 children
- Exposure
- Dynamic Risk Stratification (DRS) response categories
- Excellent responsen = 82
- Biochemical incomplete responsen = 56
- Structural incomplete responsen = 38
- Outcome
- Factors affecting disease-free survival (DFS)
Methodological detailsvalidation study
- Validation study
Main finding
As reported in the abstract
Factors associated with DFS · median follow-up 10.6 years (IQR 7.7-15.5)
- Univariate: extrathyroidal extension
- P = .002
- Univariate: lymph node metastasis
- P = .018
- Univariate: American Thyroid Association (ATA) initial risk stratification
- P = .033
- Univariate: DRS
- P = .004
- Multivariate: DRS alone significantly associated with disease-free survival (DFS)
- P = .016
Observational data: associations, not effects.
Further findings
Distribution of DRS response categories · first 2 years of follow-up
Overall survival and DFS · 10 years
- 10-year overall survival
- 100%
- 10-year DFS
- 88.7%
Original publication
Dynamic Risk Stratification for Predicting Long-term Outcomes in Pediatric Differentiated Thyroid Cancers. J Clin Endocrinol Metab. Published 29 December 2022. doi:10.
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