Pediatric Papillary Thyroid Carcinoma: Outcomes After Surgery Without Adjuvant Radioactive Iodine
An erratum to this article was published (J Clin Endocrinol Metab, 21 Jan 2025 ↗)
Authors' conclusion
Selected pediatric PTC patients, even those with lymph node metastases, may not require therapeutic 131I and can avoid the unnecessary risks of RAI while still benefitting from the excellent long-term outcomes that are well described for this disease.
Study context
- Population
- Patients <19 years with stage 1 papillary thyroid carcinoma (PTC) diagnosed 1990–2021, intentionally not treated with radioactive iodine (RAI) within a year of diagnosis; median age 16 years, 87% female, 49% with cervical lymph node metastasesof 490 PTC patients
- Participants
- 93 patients
- Exposure
- Total thyroidectomy ± neck dissection vs Lobectomy ± neck dissection vs Sistrunk procedure
- Total thyroidectomy ± neck dissectionn = 69
- Lobectomy ± neck dissectionn = 20
- Sistrunk proceduren = 4
- Outcome
- Disease-free with no further therapy
- Follow-up
- Median 5.5 years (range 1-26)
Methodological detailssingle tertiary cancer center
- Single tertiary cancer center
Main finding
As reported in the abstract
Remained disease-free with no further therapy
85/93; 91%
Persistent (n = 5) or recurrent (n = 3) disease
9%
Observational data: associations, not effects.
Further findings
Further treatment
- Ultimately received RAI
- 4 patients
- Clearly benefitted from RAI
- 1
- Additional surgery performed or planned
- 4 patients
- Excellent response at last follow-up after additional surgery
- 2
Original publication
Pediatric Papillary Thyroid Carcinoma: Outcomes After Surgery Without Adjuvant Radioactive Iodine. J Clin Endocrinol Metab. Published 20 August 2024. doi:10.
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