Risk-Directed Algorithms for Pediatric PTC Patients: Is It Time?

Excerpt

The incidence of thyroid cancer is increasing in the pediatric population overall at a rate of 4.9 annual percent change by a recent Surveillance, Epidemiology, and End Results 2001–2003 data analysis. The trend is evident in both genders, among all races, and in most regions nationally [1]. Although sensitive detection methods may have accounted for some of the increase, given the observed epidemiologic dispersion, there are likely other environmental and genetic predispositions that are contributing factors. Until these risk factors are better defined, the number of thyroid cancers diagnosed in children and adolescents will likely continue to grow. Furthermore, the rising incidence will also bring the need for optimal management algorithms in pediatric differentiated thyroid cancer (DTC) patients closer to the forefront. In Sugino et al. a large series of 227 patients aged ≤20 years who were treated from 1979 to 2012 were studied with the goal of determining if ultrasound provided reliable staging information and led to better preoperative stratification of care for pediatric patients [2]. The study demonstrated long-term outcomes that were equivalent to previously published studies by using a systematic and risk-adjusted approach to pediatric PTC patients. …