- Welch Dinauer CA, Tuttle RM, Robie DK, et al (Walter Reed Army Med Ctr, Washington, DC; Uniformed Services Univ of the Health Sciences, Bethesda, Md)
Extensive Surgery Improves Recurrence-Free Survival for Children and Young Patients With Class I Papillary Thyroid Carcinoma
J Pediatr Surg 34: 1799-1804, 1999
Pediatric papillary thyroid cancer (PTC) carries a low mortality rate but a high risk of recurrence. The effects of extensive surgery for patients with class I PTC were analyzed in 37 patients operated during 1953-1996 retrospectively. Follow-up was for median 4.6 years in all patients.
Recurrence rate was 22% with 6 recurrences to the regional lymph nodes and 2 distant metastasis in the lungs.
Freedom from recurrence was significantly greater in patients undergoing total or subtotal thyroidectomy than only lobectomy. Recurrence rate was higher for patients of 16 years or younger at the time of diagnosis.
According to R. A. Otto, the proponents of extensive surgery cite the multicentric nature of these tumors and improved efficacy of radioactive iodine therapy. In 1984 Chernobyl nuclear accident, heavily contaminated areas have seen an almost 200-fold increase in the incidence of thyroid cancer.