소아청소년 갑상선 분화암의 치료 결과
Treatment Outcome in Differentiated Thyroid Cancer in Children and Adolescents
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Background and Objectives Differentiated thyroid cancer (DTC) in children and adolescents is an advanced type of disease that has frequent recurrence and metastasis. But DTC in children and adolescents has a more favorable outcome than those in adults. We report the clinical features and treatment outcomes in children and adolescents who have undergone surgeries. Subjects and Method We studied 16 patients younger than 21 years old who were diagnosed as DTC from August 1995 to January 2011. We retrospectively reviewed for the following factors: clinical features, tumor size, multifocality, pathologic type, regional or distant metastasis, recurrence, complications, extent of surgery, postoperative I-131 therapy with medical records, imaging studies, and pathologic reports. Results The mean follow-up periods were 87 months. As an initial operation, a total thyroidectomy alone was performed on 4 patients, central compartment neck dissection on 7 patients, a modified radical neck dissection on 5 patients. On the pathologic reports, observed were 14 papillary thyroid cancer patients, 2 follicular thyroid cancer patients. Extrathyroidal extension was observed in 10 patients. Cervical lymph node involvement was noted in 11 patients. Two patients exhibited local lymph node recurrences, and one patient distant metastasis in the lung. After an additional operation and radioactive iodine therapy, they are alive at the present time, without recurrence. Conclusion Even with the limited number of cases in our study, we found that pediatric DTC has common extrathyroidal extension and lymph node metastasis. Careful surgical approach may protect postoperative complications. Regular follow up can detect recurrence earlier and could ensure disease free survival in pediatric DTC.
Abstract
Background and Objectives Differentiated thyroid cancer (DTC) in children and adolescents is an advanced type of disease that has frequent recurrence and metastasis. But DTC in children and adolescents has a more favorable outcome than those in adults. We report the clinical features and treatment outcomes in children and adolescents who have undergone surgeries. Subjects and Method We studied 16 patients younger than 21 years old who were diagnosed as DTC from August 1995 to January 2011. We retrospectively reviewed for the following factors: clinical features, tumor size, multifocality, pathologic type, regional or distant metastasis, recurrence, complications, extent of surgery, postoperative I-131 therapy with medical records, imaging studies, and pathologic reports. Results The mean follow-up periods were 87 months. As an initial operation, a total thyroidectomy alone was performed on 4 patients, central compartment neck dissection on 7 patients, a modified radical neck dissection on 5 patients. On the pathologic reports, observed were 14 papillary thyroid cancer patients, 2 follicular thyroid cancer patients. Extrathyroidal extension was observed in 10 patients. Cervical lymph node involvement was noted in 11 patients. Two patients exhibited local lymph node recurrences, and one patient distant metastasis in the lung. After an additional operation and radioactive iodine therapy, they are alive at the present time, without recurrence. Conclusion Even with the limited number of cases in our study, we found that pediatric DTC has common extrathyroidal extension and lymph node metastasis. Careful surgical approach may protect postoperative complications. Regular follow up can detect recurrence earlier and could ensure disease free survival in pediatric DTC.
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