Prognostic factors of differentiated thyroid carcinoma in children under 14 years old

Objective To investigate the clinical prognostic features of pediatric differentiated thyroid carcinoma (DTC) . Methods A retrospective analysis of clinical data of 56 cases of pediatric differentiated thyroid carcinoma under 14 years old admitted in our hospital from Aug. 2009 to Oct. 2018 was performed. Kaplan-Meier method and COX proportional hazards model were used to analyze the factors affecting the disease-free survival of patients. Results The follow-up period was from 6 months to 82 months, and the median follow-up time was 28 months. Recurrence occurred in 15 patients, with a survival rate of 100%. The 3- and 5-year disease-free survival rate was 67.4% and 63.5%. Univariate analysis showed that tumor diameter >2 cm (P=0.046) , multiple lesions (P<0.001) , cervical lymph node metastasis (P=0.008) , and extra thyroidal extension (ETE) (P=0.035) were related factors affecting postoperative recurrence, while gender, age, Hashimoto’s thyroiditis, tumor TNM stage, central lymph node metastasis and surgical approach were not related to postoperative recurrence. COX multivariate analysis showed that multiple lesions (HR: 8.815, P=0.010) was the independent factor influencing the prognosis of pediatric differentiated thyroid carcinoma. Conclusions Multiple lesion is an independent influencing factor for the recurrence of pediatric differentiated thyroid carcinoma patients after surgery. Meanwhile, total thyroidectomy and long-term follow-up should be followed. Although the metastasis rate of lymph node and distant organ are high, overall prognosis is good in pediatric DTC. Key words: Differentiated thyroid carcinoma; Children; Recurrence; Lymph node metastasis; Distant organ metastasis