2017 Sec 1 Green Book

Reprinted by permission of Int J Pediatr Otorhinolaryngol. 2016; 89:121-126.

International Journal of Pediatric Otorhinolaryngology 89 (2016) 121 e 126

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International Journal of Pediatric Otorhinolaryngology

journal homepage: http://www.ijporlonline.com/

Pediatric thyroid cancer: An update from the SEER database 2007 e 2012 * Sarah Dermody a , * , Andrew Walls c , Earl H. Harley Jr. a , b a Georgetown University School of Medicine, Washington, DC, 20007, USA b Department of Otolaryngology e Head & Neck Surgery, Georgetown University Hospital, Washington, DC, 20007, USA c Department of Surgery Division of Otolaryngology, Yale New Haven Hospital, New Haven, CT, 06510, USA

a r t i c l e i n f o

a b s t r a c t

Article history: Received 14 June 2016 Received in revised form 5 August 2016 Accepted 5 August 2016 Available online 8 August 2016

Objective: To update the medical literature regarding the incidence, disease speci fi c survival, and treatment modalities utilized in pediatric patients diagnosed with thyroid carcinomas. Study design: Cross Sectional Analysis of a National Database. Study setting: SEER Database. Methods: The National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Database was queried for all cases of pediatric thyroid cancer between the years 2007 and 2012. Patients ages 0 e 19 were grouped by histological subtypes and demographic data, overall incidence rate, and disease speci fi c survival after surgery and surgery with radiation therapy. Fifteen-Year Disease Speci fi c Survival Curves were generated and treatment modalities were compared to assess for statistical differences at each yearly interval. Results: A total of 1723 pediatric patients were identi fi ed and the average age-adjusted rate of malig- nancy was determined to be 0.59 per 100,000 patients. The incidence of pediatric thyroid cancer was approximately 4.4:1 when comparing females to males, respectively. Papillary subtype was the most common (n ¼ 1014, 58.8%), followed by follicular variant subtype (n ¼ 397, 23%), follicular subtype (n ¼ 173, 10.1%) and medullary subtype (n ¼ 139, 8.1%). As pediatric patients reached fi fteen to nineteen years of age, the incidence of papillary and follicular variant subtypes increased. Analysis of medullary thyroid cancer data revealed that incidence was highest in the zero to four age group and declined at later years. Pediatric patients presenting with metastatic medullary thyroid carcinoma maintained signi fi cantly poorer fi fteen-year disease speci fi c survival when compared to other histologic subtypes (p < 0.05). Intervention with surgery and radiation therapy provided signi fi cant bene fi t across all his- tologic subtypes when evaluating disease speci fi c survival at fi fteen-years past the initial diagnoses (p < 0.05). Conclusions: Pediatric thyroid carcinoma remains an uncommon diagnosis despite an annual increase in incidence of approximately one percent since the development of the SEER database. Overall, pediatric thyroid carcinomas demonstrate an excellent prognosis if identi fi ed early and appropriate management is available. Caucasian female patients have higher incidence of carcinoma diagnoses when compared to males. Medullary histologic subtype, especially when metastatic at initial diagnoses, demonstrates sta- tistically poorer outcomes when compared to other subtypes. © 2016 Elsevier Ireland Ltd. All rights reserved.

Keywords: Otolaryngology Pediatrics Head and neck surgery Thyroid cancer

1. Introduction

previous analyses have revealed that the incidence rate is increasing at a rate of approximately one percent annually [1,2] . Recent studies have characterized thyroid malignancies as the third

Thyroid cancer is a relatively uncommon pediatric diagnosis, yet

* This manuscript was presented as an oral presentation at the American Society of Pediatric Otolaryngology 2016 Spring Meeting in Chicago, IL on May 20th. * Corresponding author. Georgetown University School of Medicine, 3900 Reservoir Road, NW, Washington, DC, 20007, USA. E-mail address: Smd95@georgetown.edu (S. Dermody).

http://dx.doi.org/10.1016/j.ijporl.2016.08.005 0165-5876/ © 2016 Elsevier Ireland Ltd. All rights reserved.

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