Yonsei Med J.
2025 Jan;66(1):43-50. 10.3349/ymj.2023.0582.
Concurrent Association of Multifocality, Bilaterality, and Recurrence in Pediatric Papillary Thyroid Cancer Patients
- Affiliations
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- 1Departments of Surgery, Asan Medical Center, University of Ulsan Medical Center, Seoul, Korea
- 2Department of Surgery, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, Korea
- 3Departments of Pediatric Surgery, Asan Medical Center, University of Ulsan Medical Center, Seoul, Korea
- 4Departments of Radiology, Asan Medical Center, University of Ulsan Medical Center, Seoul, Korea
- 5Departments of Pathology, Asan Medical Center, University of Ulsan Medical Center, Seoul, Korea
- 6Departments of Internal Medicine, Asan Medical Center, University of Ulsan Medical Center, Seoul, Korea
- KMID: 2563354
- DOI: http://doi.org/10.3349/ymj.2023.0582
Abstract
- Purpose
Pediatric papillary thyroid cancer (PTC) is recommended to perform aggressive surgery to reduce the risk of recurrence. This study was designed to evaluate the concurrent association between multifocality, bilaterality, and the risk of recurrence in pediatric PTC.
Materials and Methods
This retrospective cohort study included pediatric patients (age <19 years) who underwent total thyroidectomy for PTC between 1996 and 2014 in a single tertiary center. Clinicopathological parameters were analyzed to evaluate the prevalence of multifocality, bilaterality, recurrence, and their association.
Results
We analyzed 58 pediatric patients with PTC. There was no factor related to the presence of multifocality or bilaterality in multivariate analysis. Also, in univariate analysis, multifocality and bilaterality were not independent risk factors of each other’s presentation (p=0.061 and p=0.061, respectively). Recurrence was observed in 19 (32.8%) patients. In multivariate analysis of recurrence, clear cell subtype, multifocality, and gross extrathyroidal extension (ETE) were independent risk factors (p=0.027, p=0.035, and p=0.038, respectively). Most recurrences (68.4%) happened during the first 4 years of follow-up after the initial thyroidectomy.
Conclusion
Multifocality and bilaterality were not independent risk factors of each other’s presentation; however, multifocality was the risk factor for recurrence in pediatric PTC. For pediatric PTC, close monitoring for recurrence within the initial 4 years is recommended, particularly in patients with clear cell subtype, multifocality, and gross ETE.
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