Initial and Dynamic Risk Stratification of Pediatric Patients with Differentiated Thyroid Cancer.

Related Articles

Initial and Dynamic Risk Stratification of Pediatric Patients with Differentiated Thyroid Cancer.

J Clin Endocrinol Metab. 2016 Nov 3;:jc20162666

Authors: Sung TY, Jeon MJ, Lee YH, Lee YM, Kwon H, Yoon JH, Chung KW, Kim WG, Song DE, Hong SJ

Abstract
BACKGROUND: The objective of this study was to evaluate the usefulness of American Thyroid Association (ATA) risk classification and dynamic risk stratification (DRS) based on the response to initial therapy in pediatric patients with differentiated thyroid cancer (DTC).
METHODS: This historical cohort study included 77 pediatric patients with DTC who underwent thyroid surgery. Clinical outcomes during median 5.3 years of follow-up were assessed according to three ATA risk groups and four DRS groups.
RESULTS: In ATA risk classification, 22%, 48%, and 30% of patients were low, intermediate and high risk group. There was no significant difference in disease-free survival (DFS) between indeterminate and low risk group. The risk of recurrent/persistent disease was significantly higher only in high risk group (HR=18.4, p=0.005). In DRS, 49%, 13%, 6% and 31% of patients were classified in excellent, indeterminate, biochemical incomplete, and structural incomplete response group, respectively. The risk of recurrent/persistent disease was significantly higher in indeterminate group (HR=10.2, p=0.045), and structural incomplete group (HR=98.7, p=0.005) compared by excellent response group.
CONCLUSION: DRS based on the response to initial therapy could be useful in addition to initial ATC pediatric risk classification to predict recurrent/persistent disease in pediatric patients with DTC.

PMID: 27809646 [PubMed - as supplied by publisher]

http://ift.tt/2eJadwM