Risk factors of post-surgery complications in children with thyroid cancer

Int J Pediatr Otorhinolaryngol. 2019 Dec;127:109673. doi: 10.1016/j.ijporl.2019.109673. Epub 2019 Sep 10.

Abstract

Introduction: Thyroid cancer in children is a hot topic because of the large clinical heterogeneity and the risk of severe complications. We aimed to study 1. The frequency, 2. Etiology, and 3. Risk factors of post-surgery complications of thyroid cancer.

Material and methods: A retrospective analysis including risk factors for post-surgery complications of patients treated for thyroid malignancies in years 2006-2018 was performed.

Results: Over a period of 12 years 22 patients with thyroid malignancy (68% female; 12.6 ± 4.0 years of age, median follow-up 6 years) were identified. Histologically, 12 (55%) patients had papillary carcinoma. Six patients (27.3%) had multiple endocrine neoplasia type 2 (MEN2) syndrome, 3 (13.7%) patients had medullary carcinoma and 1 patient had follicular carcinoma. Neck lymph node metastases were diagnosed in 8 (36.4%), distant metastases in 6 (27.3%), and both locations were involved in 4 (18.2%) patients. Six (27.3%) children had surgical complications: 1 child had unilateral vocal cord paralysis and transient hypoparathyroidism and 5 had transient hypoparathyroidism. The higher risk of surgery complications in forward stepwise logistic regression was associated in with distant metastases (R2 = 0.584, OR 52.63, p = 0.010).

Conclusions: Postoperative complications were significantly associated with presence of distant metastases. Favorable results were observed in with children with MEN2 syndrome.

Keywords: Thyroid cancer; Thyroid surgery; Thyroidectomy.

MeSH terms

  • Adenocarcinoma, Follicular / surgery*
  • Adolescent
  • Carcinoma, Neuroendocrine / surgery*
  • Carcinoma, Papillary / surgery*
  • Child
  • Female
  • Humans
  • Hypoparathyroidism / etiology
  • Lymphatic Metastasis
  • Male
  • Multiple Endocrine Neoplasia / surgery*
  • Neck
  • Neck Dissection / adverse effects
  • Postoperative Complications / etiology*
  • Retrospective Studies
  • Risk Factors
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery*
  • Thyroidectomy / adverse effects*
  • Thyroidectomy / methods
  • Vocal Cord Paralysis / etiology

Supplementary concepts

  • Thyroid cancer, medullary