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Zhou B, Hei H, Fang J, Qin J, Ge H. More aggressive biological behavior in pediatric than in adult papillary thyroid carcinoma. Asian J Surg 2024; 47:443-449. [PMID: 37805323 DOI: 10.1016/j.asjsur.2023.09.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/04/2023] [Accepted: 09/22/2023] [Indexed: 10/09/2023] Open
Abstract
OBJECTIVE Papillary thyroid carcinoma (PTC) remains a common malignancy of the endocrine system in children and adolescents. This study aimed to investigate the differences in clinical characteristics between children and adults with PTC. METHODS A total of 360 patients [ 308 adults (≥20 years) and 52 children and adolescents (<20 years)] with PTC who underwent thyroid surgery in our center from 2017 to 2022 were retrospectively analyzed. Statistical analysis and comparisons of the clinicopathological data and tumor characteristics between children and adults were performed. RESULTS Among all enrolled patients, the mean tumor diameter was 26.21 ± 12.72 mm in the pediatric group, while that in the adult group was 11.62 ± 10.21 mm, which was a significant difference (p < 0.001). Pediatric patients were more prone to central lymph node metastasis (90.38% vs. 49.35%, p<0.001), lateral lymph node metastasis (78.85% vs. 45.7%, p<0.001), capsular invasion (90.38% vs. 63.96%, p<0.001) and extrathyroidal extension (61.54% vs. 15.26%, p<0.001) than adult patients. However, the pediatric group had a lower BRAFV600E mutation rate (54.76% vs. 87.7%, p < 0.001) and lower incidence of Hashimoto's thyroiditis (15.38% vs. 30.84%, p = 0.023) than the adult group. There were no significant differences in clinicopathological factors, such as sex, multifocality and hypothyroidism. CONCLUSIONS Pediatric patients were more likely to present with advanced disease at diagnosis, including larger tumor volume, more lymph node metastasis, more extensive local invasion, and lower rates of BRAF mutation and concomitant Hashimoto's thyroiditis. Therefore, appropriate surgical management and comprehensive treatment decisions are needed for pediatric patients with PTC.
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Affiliation(s)
- Bin Zhou
- Department of Thyroid and Neck, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Hu Hei
- Department of Thyroid and Neck, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Jugao Fang
- Department of Otolaryngology, Head and Neck Surgery, Thyroid Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jianwu Qin
- Department of Thyroid and Neck, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Hong Ge
- Department of Radiation Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China.
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Xu Y, Shi L, Wu J, Li H, Wang Y, Liu B. Prognostic Value of Tumor Multifocality in Pediatric Papillary Thyroid Carcinoma: A Real-Life Multicentric Study. Otolaryngol Head Neck Surg 2023; 169:1606-1614. [PMID: 37222185 DOI: 10.1002/ohn.373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/23/2023] [Accepted: 04/29/2023] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To investigate the association of multifocality with clinical outcomes in pediatric papillary thyroid cancer. STUDY DESIGN Multicenter retrospective study of prospectively collected data. SETTING Tertiary referral center. METHODS This study included patients 18 years or younger who underwent total thyroidectomy and radioiodine ablation for papillary thyroid carcinoma (PTC) between 2005 and 2020 at 3 tertiary adult and pediatric hospitals in China. For disease-free survival (DFS), events were defined as persistent and/or recurrent diseases. The primary outcome was the association of tumor multifocality and DFS, assessed using Cox proportional hazards regression models. RESULTS One hundred and seventy-three patients (median age 16 years [range, 5-18 years]) were recruited. Multifocal diseases were seen in 59 patients (34.1%). After a median follow-up of 57 (range, 12-193 months) months, 63 (36.4%) patients had persistent diseases. There was a significant association between tumor multifocality and decreased DFS on univariable analysis (hazard ratio [HR] = 1.90, p = .01), yet it was nonsignificant after multivariate adjustment (HR = 1.20, p = .55). In a subgroup analysis of 132 pediatric patients with clinically M0 PTC, neither unadjusted HR (2.21, p = .06) nor adjusted HR (1.70, p = .27) of multifocal PTC was significantly higher in comparison to unifocal PTC. CONCLUSION In this highly selective surgical pediatric patient cohort with PTC, tumor multifocality was not an independent risk factor for decreased DFS.
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Affiliation(s)
- Yangmengyuan Xu
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lei Shi
- Department of Nuclear Medicine, Chengdu Fifth People's Hospital, Chengdu, China
| | - Jie Wu
- Department of Nuclear Medicine, Panzhihua Central Hospital, Panzhihua University, Panzhihua, China
| | - Huilan Li
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Yu Wang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Liu
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
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Scholfield DW, Lopez J, Eagan A, Antal Z, Tuttle RM, Ghossein R, LaQuaglia M, Shaha AR, Shah JP, Wong RJ, Patel SG, Ganly I. Is Multifocality a Predictor of Poor Outcome in Childhood and Adolescent Papillary Thyroid Carcinoma? J Clin Endocrinol Metab 2023; 108:3135-3144. [PMID: 37350510 PMCID: PMC10655537 DOI: 10.1210/clinem/dgad369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/09/2023] [Accepted: 06/21/2023] [Indexed: 06/24/2023]
Abstract
CONTEXT Total thyroidectomy in pediatric papillary thyroid carcinoma (PTC) is recommended in national guidelines because of the high incidence of multifocal disease (MFD). OBJECTIVE To determine the incidence of MFD in childhood and adolescent vs adult PTC and whether MFD is a predictor for poorer outcomes in childhood and adolescent PTC. METHODS We conducted an institutional review board-approved review of patients with PTC undergoing surgery (1986-2021) at Memorial Sloan Kettering Cancer Center. Clinical and pathological characteristics in patients with unifocal disease (UFD) and MFD were compared using Pearson's χ2 test. Survival outcomes were analyzed using the Kaplan-Meier method and log-rank test. Multivariate analysis assessed the impact of MFD on outcome. RESULTS MFD was less common in childhood and adolescent patients with PTC (45%; 127/283) than in adults (54%; 3023/5564; P = .002). Childhood and adolescent patients with UFD and MFD had similar tumor stage and PTC subtype at presentation, with no significant difference in histopathologic features. Median follow-up was 68 months. There was no significant difference in 5-year recurrence-free probability and overall survival was 100% in both groups. There was no significant difference in 5-year contralateral lobe PTC-free probability between patients with UFD and MFD treated with lobectomy. Multivariate analysis showed MFD was not a predictor for recurrence. CONCLUSION MFD was less common in childhood and adolescent patients with PTC than adults and was not a predictor of poor outcome on multivariate analysis, with excellent long-term outcomes in all patients with PTC. MFD does not appear to warrant completion thyroidectomy in childhood and adolescent patients selected for lobectomy.
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Affiliation(s)
- Daniel W Scholfield
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Joseph Lopez
- Division of Pediatric Head & Neck Surgery, AdventHealth for Children, Orlando, FL 32803, USA
| | - Alana Eagan
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Zoltan Antal
- Department of Pediatrics, Endocrinology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - R Michael Tuttle
- Department of Medicine, Endocrinology Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Ronald Ghossein
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Michael LaQuaglia
- Department of Surgery, Pediatric Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Ashok R Shaha
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Jatin P Shah
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Richard J Wong
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Snehal G Patel
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| | - Ian Ganly
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
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Weber T, Hummel R, Vorländer C, Zielke A, Hermann M, Krappitz A, Negele T, Dotzenrath C, Trupka A, Schabram J, Schmidtmann I, Klinger C, Lorenz K. Thyroid surgery in children and adolescents: results from a multi-institutional German and Austrian database. Br J Surg 2023; 110:1808-1814. [PMID: 37758484 DOI: 10.1093/bjs/znad255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 06/12/2023] [Accepted: 07/23/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Outcomes of paediatric thyroid surgery have only been reported in smaller series or over long intervals. The aim of this multicentre study was to describe the recent outcomes of paediatric thyroid surgery in Germany and Austria. METHODS Patients aged less than or equal to 18 years who underwent thyroid surgery and were prospectively documented in the StuDoQ|Thyroid registry between March 2017 and August 2022 were studied. RESULTS In total, 604 patients from 90 institutions were included. The mean age was 15.4 years and 75 per cent of patients were female. The most frequent benign pathologies were nodular goitre (35.6 per cent), follicular adenoma (30.1 per cent), and Graves' disease (28.5 per cent). Among 126 thyroid malignancies, papillary thyroid carcinoma was diagnosed in 77.8 per cent of patients, follicular thyroid carcinoma was diagnosed in 10.3 per cent of patients, and medullary thyroid carcinoma was diagnosed in 8.7 per cent of patients. Lymph node metastases were found in 45.9 per cent of patients with papillary thyroid carcinoma and in 36.4 per cent of patients with medullary thyroid carcinoma. Vascular invasion was found in 62.9 per cent of patients with follicular thyroid carcinoma. The mean tumour diameters were 18, 42, and 13 mm in patients with papillary thyroid carcinoma, follicular thyroid carcinoma, and medullary thyroid carcinoma respectively. Early postoperative recurrent laryngeal nerve injury was seen in 27 of 556 patients (4.9 per cent) (22 of 617 (3.6 per cent) nerves at risk with intermittent intraoperative nerve monitoring and 5 of 237 (2.1 per cent) nerves at risk with continuous intraoperative nerve monitoring). Persistent recurrent laryngeal nerve injury was documented in 4 of 556 patients (0.7 per cent). Early postoperative hypoparathyroidism correlated with Graves' disease, thyroid carcinoma, and lymph node dissection. CONCLUSION Papillary thyroid carcinoma and follicular thyroid carcinoma in children were often advanced at presentation. Persistent or recurrent lymph node metastases were mainly seen in papillary thyroid carcinoma. Overall survival was excellent, but longer follow-up is needed.
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Affiliation(s)
- Theresia Weber
- Klinik für Endokrine Chirurgie, Marienhaus Klinikum Mainz, Germany
| | - Rainer Hummel
- Klinik für Endokrine Chirurgie, Marienhaus Klinikum Mainz, Germany
| | | | - Andreas Zielke
- Klinik für Endokrine Chirurgie, Diakonie Klinikum Stuttgart, Germany
| | - Michael Hermann
- Chirurgische Abteilung, Klinik Landstr./Rudolfstiftung, Wien, Austria
| | - Anna Krappitz
- Klinik für Allgemein- und Viszeralchirurgie, Johanniter-Krankenhaus, Bonn, Germany
| | - Thomas Negele
- Klinik für Allgemein-, Visceral- und Thoraxchirurgie, Krankenhaus Martha Maria, München, Germany
| | - Cornelia Dotzenrath
- Klinik für Endokrine Chirurgie, Helios-Universitätsklinikum, Wuppertal, Germany
| | - Arnold Trupka
- Klinik für Endokrine Chirurgie, Klinikum Starnberg, Germany
| | - Jochen Schabram
- Klinik für Endokrine Chirurgie, Asklepios Klinik, Lich, Germany
| | - Irene Schmidtmann
- Institut für Medizinische Biometrie, Universitätsmedizin Mainz, Germany
| | - Carsten Klinger
- Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie, Berlin, Germany
| | - Kerstin Lorenz
- Sektion Endokrine Chirurgie, Universitätsmedizin Halle, Germany
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Li P, Jiang W, Ding Y, Zhou R, Li B, Li X, Wang W. The impact of multifocality on lateral lymph node metastasis in papillary thyroid carcinoma. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2023; 49:106944. [PMID: 37301637 DOI: 10.1016/j.ejso.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/16/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
PURPOSE Multifocality is a common feature of papillary thyroid carcinoma (PTC) and is strongly associated with unfavorable outcome, but its association with lateral lymph node metastasis (lateral LNM) remains unclear. METHODS The association between tumor foci numbers and lateral LNM was assessed with unadjusted and adjusted logistic regression. Propensity score matching analysis was used to investigate the impact of tumor foci numbers on lateral LNM. RESULTS Increasing tumor foci numbers was strongly associated with a higher risk of lateral LNM (P < 0.05). After adjusting for several confounding factors, ≥4 tumor foci can be regarded as an independent predictor of lateral LNM (multivariable adjusted OR = 1.848, P = 0.011). Similarly, compared with solitary foci, multifocality was associated with a significantly higher risk of lateral LNM after matching propensity scores (11.9% vs. 14.4%, P = 0.018), especially for patients with ≥4 tumor foci (11.2% vs. 23.4%; P = 0.001). Furthermore, age-stratified analyses revealed multifocality was significantly positively correlated with lateral LNM in younger patients (P = 0.013) compared with older patient cohorts (P = 0.669). CONCLUSIONS Overall, tumor foci numbers significantly increased the risk of lateral LNM in PTCs, especially for patients with four or more tumor foci, and patient's age should be considered when interpreting the multifocality and risk of lateral LNM.
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Affiliation(s)
- Peng Li
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan Province, China
| | - Wei Jiang
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan Province, China
| | - Ying Ding
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Ruixin Zhou
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Baizhao Li
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - Xinying Li
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan Province, China
| | - Wenlong Wang
- Department of General Surgery, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan Province, China.
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Tuli G, Munarin J, Matarazzo P, Marino A, Corrias A, Palestini N, Quaglino F, De Sanctis L. Clinical features of thyroid cancer in paediatric age. Experience of a tertiary centre in the 2000-2020 period. Endocrine 2023:10.1007/s12020-023-03366-y. [PMID: 37071323 DOI: 10.1007/s12020-023-03366-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 04/02/2023] [Indexed: 04/19/2023]
Abstract
PURPOSE To describe the clinical features of a paediatric cohort affected by differentiated thyroid cancer (DTC) followed in a tertiary Department of Paediatric Endocrinology. METHODS Clinical data of 41 patients affected by DTC in the 2000-2020 period were reviewed. RESULTS The main risk factor was autoimmune thyroiditis (39%). Cytological categories were TIR3b in 39%, TIR4 in 9.8%, TIR5 in 51.2%. After total thyroidectomy, radioiodine treatment was performed in 38 subjects (92.7%). ATA low-risk category was assigned in 11 (30.5%), intermediate-risk category in 15 (41.7%), and high-risk category in 10 patients (27.8%). Age at diagnosis was 15.1 ± 0.92 years in low-risk category, 14.7 ± 0.59 in intermediate-risk category, 11.7 ± 0.89 years in high-risk category (p = 0.01). TIR3b was manly observed in low-risk class (63.6%), while TIR5 was mainly reported in intermediate and high-risk class (60 and 80% respectively) (p = 0.04). Post-surgery stimulated thyroglobulin was increased in high-risk class (407.8 ± 307.1 ng/ml) [p = 0.04]. Tumour size was larger in high-risk category (42.6 ± 2.6 mm), than in low and intermediate-risk categories (19.4 ± 3.5 mm and 28.5 ± 3.9 mm, respectively) (p = 0.008). Patients in intermediate and high-risk categories displayed more tumour multifocality (60 and 90% respectively) (p < 0.005). Disease relapse was mainly observed in high risk category (40%, p = 0.04). CONCLUSION DTC in childhood is more aggressive than in adults, but the overall survival rate is excellent. The therapeutic approach is still heterogeneous, especially in low-risk category. Further studies are needed to standardise management and reduce disease persistence in childhood.
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Affiliation(s)
- Gerdi Tuli
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy.
| | - Jessica Munarin
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Patrizia Matarazzo
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Antonio Marino
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
- Department of Pediatric Endocrinology, Regina Margherita Children's Hospital, Turin, Italy
| | - Andrea Corrias
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
| | | | - Francesco Quaglino
- Department of General Surgery, Maria Vittoria Hospital, ASL City of Turin, Turin, Italy
| | - Luisa De Sanctis
- Department of Public Health and Pediatrics, University of Turin, Turin, Italy
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Thyroid Nodules on Ultrasound in Children and Young Adults: Comparison of Diagnostic Performance of Radiologists' Impressions, ACR TI-RADS, and a Deep Learning Algorithm. AJR Am J Roentgenol 2023; 220:408-417. [PMID: 36259591 DOI: 10.2214/ajr.22.28231] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND. In current clinical practice, thyroid nodules in children are generally evaluated on the basis of radiologists' overall impressions of ultrasound images. OBJECTIVE. The purpose of this article is to compare the diagnostic performance of radiologists' overall impression, the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS), and a deep learning algorithm in differentiating benign and malignant thyroid nodules on ultrasound in children and young adults. METHODS. This retrospective study included 139 patients (median age 17.5 years; 119 female patients, 20 male patients) evaluated from January 1, 2004, to September 18, 2020, who were 21 years old and younger with a thyroid nodule on ultrasound with definitive pathologic results from fine-needle aspiration and/or surgical excision to serve as the reference standard. A single nodule per patient was selected, and one transverse and one longitudinal image each of the nodules were extracted for further evaluation. Three radiologists independently characterized nodules on the basis of their overall impression (benign vs malignant) and ACR TI-RADS. A previously developed deep learning algorithm determined for each nodule a likelihood of malignancy, which was used to derive a risk level. Sensitivities and specificities for malignancy were calculated. Agreement was assessed using Cohen kappa coefficients. RESULTS. For radiologists' overall impression, sensitivity ranged from 32.1% to 75.0% (mean, 58.3%; 95% CI, 49.2-67.3%), and specificity ranged from 63.8% to 93.9% (mean, 79.9%; 95% CI, 73.8-85.7%). For ACR TI-RADS, sensitivity ranged from 82.1% to 87.5% (mean, 85.1%; 95% CI, 77.3-92.1%), and specificity ranged from 47.0% to 54.2% (mean, 50.6%; 95% CI, 41.4-59.8%). The deep learning algorithm had a sensitivity of 87.5% (95% CI, 78.3-95.5%) and specificity of 36.1% (95% CI, 25.6-46.8%). Interobserver agreement among pairwise combinations of readers, expressed as kappa, for overall impression was 0.227-0.472 and for ACR TI-RADS was 0.597-0.643. CONCLUSION. Both ACR TI-RADS and the deep learning algorithm had higher sensitivity albeit lower specificity compared with overall impressions. The deep learning algorithm had similar sensitivity but lower specificity than ACR TI-RADS. Interobserver agreement was higher for ACR TI-RADS than for overall impressions. CLINICAL IMPACT. ACR TI-RADS and the deep learning algorithm may serve as potential alternative strategies for guiding decisions to perform fine-needle aspiration of thyroid nodules in children.
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Abstract
Thyroid cancer is rare in children but its incidence is increasing. Recent data have clarified important similarities and differences between thyroid cancers originating in childhood and in adulthood. The genetic drivers of pediatric thyroid cancers are similar to those in adult tumors but comprise more gene fusions and fewer point mutations. Clinically, despite frequent metastatic spread, pediatric thyroid cancer has an excellent prognosis and mortality is rare. Therefore, treatment approaches must weigh carefully the morbidity of thyroid cancer treatments against their benefits. Current key questions include which children require total thyroidectomy rather than more limited-and safer-lobectomy, and in which children does the benefit of radioactive iodine therapy outweigh its risk of inducing a secondary malignancy. Finally, molecular therapies targeting genetic drivers of thyroid cancer now provide effective treatment for children with progressive, radioiodine-refractory disease, as well as opportunities to explore novel neoadjuvant uses that facilitate therapeutic surgery or radioactive iodine.
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Affiliation(s)
- Christine E Cherella
- Thyroid Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Ari J Wassner
- Thyroid Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
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Coutant R, Lugat A, Mirallié É, Oliver-Petit I, Stoupa A, Drui D. SFE-AFCE-SFMN 2022 Consensus on the management of thyroid nodules : Thyroid nodules in children. ANNALES D'ENDOCRINOLOGIE 2022; 83:431-434. [PMID: 36283462 DOI: 10.1016/j.ando.2022.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The SFE-AFCE-SFMN 2022 consensus deals with the management of thyroid nodules, a condition that is a frequent reason for consultation in endocrinology. In more than 90% of cases, patients are euthyroid, with benign non-progressive nodules that do not warrant specific treatment. The clinician's objective is to detect malignant thyroid nodules at risk of recurrence and death, toxic nodules responsible for hyperthyroidism or compressive nodules warranting treatment. The diagnosis and treatment of thyroid nodules requires close collaboration between endocrinologists, nuclear medicine physicians and surgeons, but also involves other specialists. Therefore, this consensus statement was established jointly by 3 societies: the French Society of Endocrinology (SFE), French Association of Endocrine Surgery (AFCE) and French Society of Nuclear Medicine (SFMN); the various working groups included experts from other specialties (pathologists, radiologists, pediatricians, biologists, etc.). The present section deals with the specific aspects of the management of euthyroid nodules in patients under 18 years of age.
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Affiliation(s)
- Régis Coutant
- Service d'Endocrinologie et Diabétologie Pédiatrique et Centre de Référence des Maladies Rares de la Thyroïde et des Récepteurs Hormonaux, CHU Angers, 49000 Angers, France
| | - Alexandre Lugat
- Nantes Université, CHU Nantes, Service d'Oncologie Médicale, 44000 Nantes, France
| | - Éric Mirallié
- Nantes Université, CHU Nantes, Service de Chirurgie Digestive et Endocrinienne, Institut des Maladies de l'Appareil Digestif, 44000 Nantes, France
| | | | - Athanasia Stoupa
- Service de d'Endocrinologie, Gynécologie et Diabétologie Pédiatrique. Hôpital Universitaire Necker Enfants-Malades, APHP, Paris, France
| | - Delphine Drui
- Nantes Université, CHU Nantes, Service d'Endocrinologie-Diabétologie et Nutrition, l'institut du thorax, 44000 Nantes, France.
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Exposure to multiple trace elements and thyroid cancer risk in Chinese adults: A case-control study. Int J Hyg Environ Health 2022; 246:114049. [DOI: 10.1016/j.ijheh.2022.114049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/08/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022]
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