EP90 – Endemic, Sporadic and Radio-induced Thyroid Cancer in children and Adolescents: epidemiology, clinical manifestations, and surgical results of treatment


    Romanchishen, Anatoly1; Demidchik, Yurii2; Gostimskii, Alexander1; Privalov, Valerii3;Vabalayte, Kristina1
    1 Department of hospital surgery of Saint-Petersburg Pediatric Medical University, Saint-Petersburg Center of Endocrine Surgery and Oncology, Saint-Petersburg, Russia
    2 Belarus Medical Academy, Minsk, Belarus
    3 South Ural Medical University, Chelyabinsk, Chelyabinsk Oblast, Russia


    Purpose:  Choosing of a rational surgery in Thyroid Cancer (TC) in children and adolescents with or without history of irradiation.

    Materials/Methods:  We included 1942 TC children representing 3 groups:
    1 – 190 patients from Chelyabinsk and Archangelsk (TC in endemic goiter zones);
    2 – 105 patients from St.-Petersburg (sporadic TC);
    3 – 1647 patients from Minsk and Kiev (with radiation-induced TC).

    Results: Patients average age made 13.4+0.7 (15.5, 16.2, 13.4 in groups accordingly). There were 655 boys and 1287 girls, ratio 1:2 (1:3.8, 1:2.9, and 1:1.8). TC lymphatic metastases rate made – 61.9% (29.0%, 53.0%, 66.3%); extra-thyroid tumor spreading – 18.4% (4.5%, 17.9%, 20.0%) multi-central TC growths – 19.7% (13.3%, 8.5%, and 21.1%) of cases. Preoperative distant TC metastases were revealed in 12.1% (1.6%, 10.5%, 13.4%). During the nearest 15 years, additional remote metastases were found in 8.9% (1.1%, 2,4%, and 10.2%). Organ-saving operations were performed in 38.0% (88.2%, 64.3%, 30.6%).  Postoperative complications rate (laryngeal muscles palsy, hypoparathyroidism) made 7.9% (4.7%, 2.6%, 8.6%). Repeated lymph node metastases were found in 9.0% (4.4%, 8.4%, 9.6%). Follow-up (12 – 20 years) results of TC were performed in 95%s.

    Conclusion: Aggressiveness of TC in children and adolescents was increased in row: iodine-deficient, sporadic and radio-induced thyroid carcinomas. They manifested as more often extracapsular growth, and regional and distant metastases of tumors. Thyroidectomies were performed by experienced surgeons and were supplemented by radioiodine therapy (if needed), which prevented relapses of the disease and provided cure in more than 95% of children and adolescent patients.


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    Rocco Bellatone, Co-Chair
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    Gregory W. Randolph, MD
    Bryan McIver, MD
    Jeremy Freeman, MD
    Ian J. Witterick, MD
    Ashok R. Shaha, MD
    Jatin P. Shah, MD