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소아청소년 갑상선암 환자들의 예후인자

Age and Tumor Size is a Prognostic Factor in Pediatric/Adolescent Differentiated Thyroid Carcinoma

대한두경부종양학회지 2020년 36권 2호 p.9 ~ 15
변병현, 이국행, 김동호, 임중섭, 임일한, 임상무, 이병철, 이준아,
소속 상세정보
변병현 ( Byun Byung-Hyun ) - Korea Cancer Center Hospital Department of Nuclear Medicine
이국행 ( Lee Guk-Haeng ) - Korea Cancer Center Hospital Department of Otorhinolaryngology
김동호 ( Kim Dong-Ho ) - Korea Cancer Center Hospital Department of Pediatrics
임중섭 ( Lim Jung-Sub ) - Korea Cancer Center Hospital Department of Pediatrics
임일한 ( Lim Il-Han ) - Korea Cancer Center Hospital Department of Nuclear Medicine
임상무 ( Lim Sang-Moo ) - Korea Cancer Center Hospital Department of Nuclear Medicine
이병철 ( Lee Byeong-Cheol ) - Korea Cancer Center Hospital Department of Otorhinolaryngology
이준아 ( Lee Jun-Ah ) - Korea Cancer Center Hospital Department of Pediatrics

Abstract


Background/Objectives: To analyze the clinical characteristics of differentiated thyroid cancer (DTC) in children and adolescents.

Materials & Methods: Medical records of 31 DTC cases that were diagnosed and treated at Korea Cancer Center Hospital between 2002 and 2018 were retrospectively reviewed.

Results: Most cases were papillary carcinoma (n=26), with female predominance (n=25). Median age was 16.4 years (range, 11.9-18.6 years). Extrathyroidal extension was present in 24 cases. Twenty cases had tumor involvement at cervical lymph nodes and three had lung metastasis. Twenty-two patients received radioactive iodide treatment with a median cumulative dose of 300 mCi (range, 100-920 mCi). During a median follow-up of 68.2 months (range, 2.3-191.4 months), serum thyroglobulin level was elevated in 15 patients. Among them, two cases had remnant thyroid tissue, 4 had recurrence at cervical lymph nodes, and the remaining 9 did not have any detectable lesion. All were alive, and 5-year event-free survival (EFS) was 45.2±10.1%. Age £15 years, tumor size, lymph node status (N1b), and distant metastasis had negative effects on EFS. On multivariate analysis, age and tumor size had prognostic significance.

Conclusion: For DTC of children and adolescents (£18 years old), age ≤15 years and tumor size were prognostic factor. Therefore, patients in this age group need meticulous follow-up. Further studies are necessary to answer the potential influence of age on the incidence and behavior of DTC.

키워드

Thyroid carcinoma; Children; Adolescent; Prognosis

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