Clinical analysis of thyroid carcinoma in 110 children and adolescents / 中华实用儿科临床杂志

ABSTRACT

Objective To study the clinical and pathologic factors for prognosis of children and adolescents with thyroid carcinoma.Methods Clinicopathological data of 110 children and adolescents with thyroid carcinoma at the Affiliated Tumor Hospital of Zhengzhou University from January 1984 to March 2008 were collected and reviewed in this study.Univariate analysis was performed by using Log－rank test to determine predictors of survival,and multiva-riable analysis was performed by a Cox regression model.Results The overall 5－ year and 10 －year survival rates were 95.5%,88.2%,respectively.Gender and histopathologic typing were not related to prognosis.The 5 －year and 10－year survival rates in group ≤12 years old were 91.7% and 81.3%,and those in group ＞12 years old were 98. 4% and 93.5%,respectively.The 5－year and 10－year survival rates in stage T1 and T2 were 100.0%,in stage T3 were 100.0% and 66.7%,respectively,and those in stage T4 were 58.3% and 0.The 5－year and 10－year sur-vival rates in N0 group and N1a group were 100.0%,and those in N1b group were 93.4% and 82.9%,respectively. For patients without the distant metastasis group,the 5－year and and 10－year survival rates were all 96.9%,which were significantly higher than those in the distant metastasis group(84.6%,23.1%).The 5－year and 10－year sur-vival rates in groupⅠwere all 97.8%,those in groupⅡwere 84.6% and 23.1%,respectively,and those in groupⅣwere all 75. 0%.The 5－year and 10－year survival rates in the solitary lesions group were 98.7%,in the multiple le-sions group were 88.2% and 64.7%,respectively.For differentiated thyroid carcinoma,the 5－year and 10－year sur-vival rates in low,and medium risk groups were all 100.0%and those in high risk group were 83.3% and 50.0%,re-spectively.There was a significant relationship between survival and age group,T stage,N stage,M stage,TNM stage, the number of lesions,and risk stratification(all P＜0.05).The Cox regression analysis showed that T stage and M stage were the independent prognostic factors.Conclusions The primary tumor and distant metastatic are important factors affecting the prognosis of children and adolescents.Earlier diagnosis for primary tumor and aggressive manage-ments for metastatic lesions are critical to the survival rate of children and adolescents with thyroid carcinoma.