Bilateral papillary thyroid cancer in children: Risk factors and frequency of postoperative diagnosis
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In brief
In brief
Retrospective study of 172 pediatric papillary thyroid cancer patients finds 38% have bilateral disease, with nearly one-quarter diagnosed only after total thyroidectomy. Multifocal ultrasound findings and nodules >2cm predict bilateral involvement and more aggressive pathologic features, supporting total thyroidectomy as standard approach in children.
Written by the GCMD Library team from the article.
Background
The recommendation for children with papillary thyroid cancer (PTC) is total thyroidectomy (TT) based on the incidence of bilateral disease. Evaluating this assumption, we reviewed the characteristics of bilateral PTC in a large cohort of children.
Methods
A retrospective chart review for patients surgically treated for PTC from 2009 to 2018 analyzing preoperative risk factors, ultrasound findings, and pathology results was performed. Bilateral disease was defined as pathologic PTC in the contralateral lobe, including microscopic disease.
Results
Of the 172 patients included, 38.4% had bilateral disease with 23% diagnosed postoperatively. Multifocal disease on ultrasound was associated with bilateral disease (OR 2.9, 95% CI 1.5–5.9, p = 0.002). Nodule dimension >2 cm was associated with increased risk for postoperative bilateral disease (OR 3.5, 95% CI 1.6–7.4, p = 0.001). Patients with bilateral disease were more likely to have extrathyroidal extension, lymphovascular invasion, positive central lymph nodes, and extranodal extension (p