• Article

Characteristics and outcomes of children and adolescents with high-risk papillary thyroid carcinoma in the SEER database

Poster #282 from Abstracts of the 87th Annual Meeting of the American Thyroid Association

Approximately 10% to 20% of pediatric patients with papillary
thyroid carcinoma (PTC) will have distant metastases. Proper risk
stratification of children with PTC is important to optimize treatment.
In 2015, the American Thyroid Association (ATA) published
guidelines for the management of children with PTC. Data from the
Surveillance, Epidemiology, and End Results (SEER) populationbased
database were used to describe the characteristics and outcomes
of children and adolescents with PTC who were classified as
high-risk per the ATA guidelines. Using SEER 18, we analyzed
patients less than 20 years of age with PTC diagnosed between 2004
and 2014. TNM staging was used to categorize patients into the ATA
pediatric high-risk group, which included patients with either locally
invasive tumors (T4) or distant metastatic disease (M1). Of 1861
patients with PTC, 110 (6%) were identified as high-risk. Seventy-six
patients had T4 disease and 54 patients had M1 disease; 20 of those
patients had both. Eighty (73%) patients were female. Sixty-two
(56%) patients were between 15 and 19 years old at diagnosis and 39
(35%) were between 10 and 14 years. Fifty-nine (54%) patients were
non-Hispanic White, 33 (30%) were Hispanic, 6 (5%) were non-
Hispanic Black, and 12 (11%) were other. Ninety percent of the
patients underwent a total thyroidectomy and 6% underwent a near
total thyroidrectomy. A total of 96 (87%) patients received irradiation.
Two patients died secondary to their thyroid malignancy within
5 years after diagnosis. Despite having widespread disease, pediatric
and adolescent patients with high-risk PTC per ATA classification
have an excellent prognosis. Major limitations of this study are the
lack of recurrence data and inability to distinguish high-risk nodal
disease in the SEER database. Prospective research is warranted to
study long-term outcomes and side effects of radiation.

Citation

Mahajan, P., Danysh, H. E., Chelius, DC., & Venkatramani, R. (2017). Characteristics and outcomes of children and adolescents with high-risk papillary thyroid carcinoma in the SEER database. Thyroid, 27(S1), A92-A93. https://doi.org/10.1089/thy.2017.29046.abstracts