Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2010

01-10-2010 | Healthcare Policy and Outcomes

Utilization of Total Thyroidectomy for Differentiated Thyroid Cancer in Children

Authors: Mehul V. Raval, MD, David J. Bentrem, MD, Andrew K. Stewart, MA, Clifford Y. Ko, MD, Marleta Reynolds, MD

Published in: Annals of Surgical Oncology | Issue 10/2010

Login to get access

Abstract

Purpose

Recent recommendations suggest that total thyroidectomy (TT) is the surgical management of choice for differentiated thyroid cancer in children. The objective of this study is to assess trends in extent of surgical resection for differentiated thyroid cancer in children over the past two decades and to identify patient, tumor or hospital factors associated with use of TT.

Patients and Methods

Of 8,013 patients (aged 0–21 years) with differentiated thyroid cancer from the National Cancer Data Base (1985–2007), 5,933 (74%) underwent TT. Trends in extent of surgery were examined. Logistic regression was used to identify factors that predict use of TT.

Results

Use of TT increased from 50.6% in 1985 to 84% in 2007 (P < 0.001). Patients were more likely to undergo TT if they had higher household income or had private insurance (P = 0.002 and P = 0.037). Patients were more likely to undergo TT if they had larger tumors or if there were nodal metastases present at time of resection (both P < 0.001). After adjusting for patient and tumor factors, patients treated at high-volume or Children’s Oncology Group hospitals were more likely to undergo TT than patients treated at low-volume or non-Children’s Oncology Group hospitals (P < 0.001).

Conclusions

Overall utilization of TT in children with differentiated thyroid cancer has steadily increased over the past 23 years in the USA. Variations in use of TT are not only related to tumor factors including size and nodal involvement, but also are also related to socioeconomic and hospital factors, demonstrating disparities in care.
Literature
1.
Ries LAG, Smith MA, Gurney JG, et al. Cancer Incidence and Survival among Children and Adolescents: United States SEER Program 1975-1995, National Cancer Institute, SEER Program. Bethesda, MD: NIH Pub. No. 99-4649, 1999.
2.
Hogan AR, Zhuge Y, Perez EA, et al. Pediatric thyroid carcinoma: incidence and outcomes in 1753 patients. J Surg Res. 2009;156(1):167–72.CrossRefPubMed
3.
Demidchik YE, Demidchik EP, Reiners C, et al. Comprehensive clinical assessment of 740 cases of surgically treated thyroid cancer in children of Belarus. Ann Surg. 2006;243(4):525–32.CrossRefPubMed
4.
Okada T, Sasaki F, Takahashi H, et al. Management of childhood and adolescent thyroid carcinoma: long-term follow-up and clinical characteristics. Eur J Pediatr Surg. 2006;16(1):8–13.CrossRefPubMed
5.
Dinauer CA, Breuer C, Rivkees SA. Differentiated thyroid cancer in children: diagnosis and management. Curr Opin Oncol. 2008;20(1):59–65.CrossRefPubMed
6.
Grigsby PW, Gal-or A, Michalski JM, Doherty GM. Childhood and adolescent thyroid carcinoma. Cancer. 2002;95(4):724–9.CrossRefPubMed
7.
Cooper DS, Doherty GM, Haugen BR, et al. Management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2006;16(2):109–42.CrossRefPubMed
8.
La Quaglia MP, Black T, Holcomb GW, 3rd, et al. Differentiated thyroid cancer: clinical characteristics, treatment, and outcome in patients under 21 years of age who present with distant metastases. A report from the Surgical Discipline Committee of the Children’s Cancer Group. J Pediatr Surg. 2000;35(6):955–9; discussion 960.
9.
10.
11.
Winchester DP, Stewart AK, Bura C, Jones RS. The National Cancer Data Base: a clinical surveillance and quality improvement tool. J Surg Oncol. 2004;85(1):1–3.CrossRefPubMed
12.
Bilimoria KY, Stewart AK, Winchester DP, Ko CY. The National Cancer Data Base: a powerful initiative to improve cancer care in the United States. Ann Surg Oncol. 2008;15(3):683–90.CrossRefPubMed
13.
Grovas A, Fremgen A, Rauck A, et al. The National Cancer Data Base report on patterns of childhood cancers in the United States. Cancer. 1997;80(12):2321–32.CrossRefPubMed
14.
Lange JR, Palis BE, Chang DC, et al. Melanoma in children and teenagers: an analysis of patients from the National Cancer Data Base. J Clin Oncol. 2007;25(11):1363–8.CrossRefPubMed
15.
16.
17.
18.
19.
Newman KD, Black T, Heller G, et al. Differentiated thyroid cancer: determinants of disease progression in patients < 21 years of age at diagnosis: a report from the Surgical Discipline Committee of the Children’s Cancer Group. Ann Surg. 1998;227(4):533–41.CrossRefPubMed
20.
International Classification of Diseases for Oncology. 3rd ed. Geneva: World Helath Organization, 2000.
21.
FORDS: Facility Oncolgy Registry Data Standards—Revised for 2007. Chicago, IL: Commision on Cancer, American College of Surgeons, 2007.
22.
23.
Harness JK, Thompson NW, McLeod MK, et al. Differentiated thyroid carcinoma in children and adolescents. World J Surg 1992;16(4):547–53; discussion 553–4.CrossRefPubMed
24.
Spinelli C, Bertocchini A, Antonelli A, Miccoli P. Surgical therapy of the thyroid papillary carcinoma in children: experience with 56 patients < or = 16 years old. J Pediatr Surg. 2004;39(10):1500–5.CrossRefPubMed
25.
Misiakos EP, Liakakos T, Macheras A, et al. Total thyroidectomy for the treatment of thyroid diseases in an endemic area. South Med J. 2006;99(11):1224–9.PubMed
26.
Haveman JW, van Tol KM, Rouwe CW, et al. Surgical experience in children with differentiated thyroid carcinoma. Ann Surg Oncol. 2003;10(1):15–20.CrossRefPubMed
27.
Shapiro NL, Bhattacharyya N. Population-based outcomes for pediatric thyroid carcinoma. Laryngoscope. 2005;115(2):337–40.CrossRefPubMed
28.
Karakoc D, Erol T, Memmedova B, et al. Thyroid surgery: what has changed from (1970 to 2004): a Turkish perspective. Am J Surg. 2009;198(1):12–6.CrossRefPubMed
29.
Bilimoria KY, Bentrem DJ, Linn JG, et al. Utilization of total thyroidectomy for papillary thyroid cancer in the United States. Surgery. 2007;142(6):906–13.CrossRefPubMed
30.
Hay ID, Thompson GB, Grant CS, et al. Papillary thyroid carcinoma managed at the Mayo Clinic during six decades (1940-1999): temporal trends in initial therapy and long-term outcome in 2444 consecutively treated patients. World J Surg. 2002;26(8):879–85.CrossRefPubMed
31.
Liu JH, Zingmond DS, McGory ML, et al. Disparities in the utilization of high-volume hospitals for complex surgery. JAMA. 2006;296(16):1973–80.CrossRefPubMed
32.
Rachmiel M, Charron M, Gupta A, et al. Evidence-based review of treatment and follow up of pediatric patients with differentiated thyroid carcinoma. J Pediatr Endocrinol Metab. 2006;19(12):1377–93.PubMed
33.
Massimino M, Gasparini M, Ballerini E, Del Bo R. Primary thyroid carcinoma in children: a retrospective study of 20 patients. Med Pediatr Oncol. 1995;24(1):13–7.CrossRefPubMed
34.
Wada N, Sugino K, Mimura T, et al. Pediatric differentiated thyroid carcinoma in stage I: risk factor analysis for disease free survival. BMC Cancer. 2009;9:306.
35.
Zimmerman D, Hay ID, Gough IR, et al. Papillary thyroid carcinoma in children and adults: long-term follow-up of 1039 patients conservatively treated at one institution during three decades. Surgery. 1988;104(6):1157–66.PubMed
36.
La Quaglia MP, Corbally MT, Heller G, et al. Recurrence and morbidity in differentiated thyroid carcinoma in children. Surgery. 1988;104(6):1149–56.PubMed
37.
McHenry C, Smith M, Lawrence AM, et al. Nodular thyroid disease in children and adolescents: a high incidence of carcinoma. Am Surg. 1988;54(7):444–7.PubMed
38.
Ceccarelli C, Pacini F, Lippi F, et al. Thyroid cancer in children and adolescents. Surgery. 1988;104(6):1143–8.PubMed
39.
Halac I, Zimmerman D. Thyroid nodules and cancers in children. Endocrinol Metab Clin North Am. 2005;34(3):725–44, x.
40.
Raab SS, Silverman JF, Elsheikh TM, et al. Pediatric thyroid nodules: disease demographics and clinical management as determined by fine needle aspiration biopsy. Pediatrics. 1995;95(1):46–9.PubMed
41.
Hod N, Hagag P, Baumer M, et al. Differentiated thyroid carcinoma in children and young adults: evaluation of response to treatment. Clin Nucl Med. 2005;30(6):387–90.CrossRefPubMed
42.
Welch Dinauer CA, Tuttle RM, Robie DK, et al. Clinical features associated with metastasis and recurrence of differentiated thyroid cancer in children, adolescents and young adults. Clin Endocrinol (Oxf). 1998;49(5):619–28.CrossRef
43.
Parisi MT, Mankoff D. Differentiated pediatric thyroid cancer: correlates with adult disease, controversies in treatment. Semin Nucl Med. 2007;37(5):340–56.CrossRefPubMed
44.
Dackiw AP, Zeiger M. Extent of surgery for differentiated thyroid cancer. Surg Clin North Am. 2004;84(3):817–32.CrossRefPubMed
45.
Kebebew E, Clark OH. Differentiated thyroid cancer: “complete” rational approach. World J Surg. 2000;24(8):942–51.CrossRefPubMed
46.
Jarzab B, Handkiewicz Junak D, Wloch J, et al. Multivariate analysis of prognostic factors for differentiated thyroid carcinoma in children. Eur J Nucl Med. 2000;27(7):833–41.CrossRefPubMed
47.
Bargren AE, Meyer-Rochow GY, Delbridge LW, et al. Outcomes of surgically managed pediatric thyroid cancer. J Surg Res. 2009;156(1):70–3.CrossRefPubMed
48.
Raval MV, Browne M, Chin AC, et al. Total thyroidectomy for benign disease in the pediatric patient–feasible and safe. J Pediatr Surg. 2009;44(8):1529–33.CrossRefPubMed
49.
Filho JG, Kowalski LP. Postoperative complications of thyroidectomy for differentiated thyroid carcinoma. Am J Otolaryngol. 2004;25(4):225–30.CrossRefPubMed
50.
Sosa JA, Bowman HM, Tielsch JM, et al. The importance of surgeon experience for clinical and economic outcomes from thyroidectomy. Ann Surg. 1998;228(3):320–30.CrossRefPubMed
51.
Handkiewicz-Junak D, Wloch J, Roskosz J, et al. Total thyroidectomy and adjuvant radioiodine treatment independently decrease locoregional recurrence risk in childhood and adolescent differentiated thyroid cancer. J Nucl Med. 2007;48(6):879–88.CrossRefPubMed
52.
Borson-Chazot F, Causeret S, Lifante JC, et al. Predictive factors for recurrence from a series of 74 children and adolescents with differentiated thyroid cancer. World J Surg. 2004;28(11):1088–92.CrossRefPubMed
53.
DeGroot LJ, Kaplan EL, McCormick M, Straus FH. Natural history, treatment, and course of papillary thyroid carcinoma. J Clin Endocrinol Metab. 1990;71(2):414–24.CrossRefPubMed
54.
Bilimoria KY, Bentrem DJ, Ko CY, et al. Extent of surgery affects survival for papillary thyroid cancer. Ann Surg. 2007;246(3):375–384.CrossRefPubMed
Metadata
Title
Utilization of Total Thyroidectomy for Differentiated Thyroid Cancer in Children
Authors
Mehul V. Raval, MD
David J. Bentrem, MD
Andrew K. Stewart, MA
Clifford Y. Ko, MD
Marleta Reynolds, MD
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1083-3

Other articles of this Issue 10/2010

Annals of Surgical Oncology 10/2010 Go to the issue

Colorectal Cancer

Ratio of Metastatic to Resected Lymph Nodes as a Prognostic Factor in Node-Positive Colorectal Cancer

Colorectal Cancer

Limited Value of Staging Squamous Cell Carcinoma of the Anal Margin and Canal Using the Sentinel Lymph Node Procedure: A Prospective Study with Long-Term Follow-Up

Endocrine Tumors

Malignant Adrenal Neoplasm Masquerading as Worrisome Adrenal Hemorrhage

Translational Research and Biomarkers

Higher Expression of the Heterogeneous Nuclear Ribonucleoprotein K in Melanoma

Translational Research and Biomarkers

Polymorphisms in Apoptosis-Related Genes and Survival of Patients with Early-Stage Non-Small-Cell Lung Cancer

Bone and Soft Tissue Sarcomas

Role of Surgery Combined with Kinase Inhibition in the Management of Gastrointestinal Stromal Tumor (GIST)