Therapeutic outcome and prognosis in young patients with papillary and follicular thyroid cancer

J. Lin; C. Huang; T. Chao; C. Hseuh; K. Lin; S. Lin

The aims of this study are to assess the clinical characteristics of papillary and follicular thyroid cancer in young patients. We performed a retrospective analysis of 116 patient aged 20 years who underwent thyroidectomy and a mean follow-up of 11.1±0.6 years. There were 28 (24.1%) patients were classified into the residual cancer or relapse groups. Two of the 28 patients died of thyroid cancer. Thirteen patients who showed relapsed underwent 131I whole body scan; six of the 13 patients were diagnosed with distant metastases. Among the young patients, the 5- and 10-year progression-free survival rates were 79.1 and 73.4%, respectively. In conclusion, the progression-free survival in young patients with papillary and follicular thyroid cancer was lower than the patients of age 20–45 years; otherwise, cancer survival higher than age group over or equal 45 year-old.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector

**Table 1** Characteristics of papillary and follicular thyroid carcinoma patients in different age groups.
Group	≤20 years (n=116)	>20 and <45 years (n=1.308)	≥ 45 years (n=1.119)	P value
Age (years) (S.D.)	17.1 (3.3)	33.8 (6.3)	56.6 (9.1)	a,b,c
Gender (female/male) (ratio)	92/24 (3.8)	1,091/217 (5.0)	841/278 (3.0)	0.0001
Histology (papillary/follicular) (ratio)	98/18 (5.4)	1,201/107 (11.2)	956/163 (5.9)	0.0001
TNM stage (I/II/III/IV)	109/7/0/0	1,267/41/0/0	361/202/163/393	0.0001
Microcarcinoma (%)	6 (5.6%)	226 (18.4%)	204 (19.9%)	0.0014
Tumor size (cm)	3.0 (0.1)	2.3 (0.1)	2.7 (0.1)	a, c
Multicentric (%)	11 (9.5%)	191 (14.6%)	259 (23.1%)	0.0001
Surgical method* (less aggressive)	28 (24.1%)	260 (19.9%)	222 (19.8%)	0.5315
Status at diagnosis
Local neck (%)	36 (31.0%)	369 (28.3%)	364 (32.5%)
Distant metastasis (%)	7 (6.0%)	41 (3.1%)	128 (11.4%)
Post-op 131I uptake (%)	10.3 (1.5)	7.9 (0.4)	7.4 (0.4)	b
Post-op 131I ablation (%)	102 (87.9%)	1,102 (84.3%)	912 (81.5%)	0.0742
Postoperative Tg∧ (ng/ml)	182 (93)	112 (35)	389 (90)	c
External radiation	9 (7.8%)	41 (3.1%)	125 (11.2%)	0.0001
Relapse / residual	13/15	78/63	113/179	0.0083
Disease free	44 (37.9%)	486 (37.2%)	293 (26.2%)	0.0001
2nd primary cancer	3 (2.6%)	46 (3.5%)	114 (0.2%)	0.0001
Follow-up period (years)	11.1 (0.6)	9.6 (0.2)	7.3 (0.2)	a, b, c
Thyroid cancer mortality (%)	2 (1.7%)	27 (2.1%)	159 (14.2%)	0.0001
Total mortality (%)	3 (2.6%)	40 (3.1%)	256 (23.0%)	0.0001
Data are mean (SD) unless otherwise stated. Surgical method*, less aggressive than total thyroidectomy. Postoperative Tg∧, serum thyroglobulin level 4–6 weeks after thyroid operation. a: ≤20 years vs >20 and <45 years; b: ≤20 years vs ≥45 years; c: >20 and <45 years vs ≥45 years, P<0.001.

Figure 1 Progression-free survival (A) and thyroid cancer-specific survival (B) curves of the thyroid cancer patients in the different age groups. (FIG 2A: <20 years vs > 20 years to < 45 years, P = 0.0001; < 20 years vs > 40 years, P = 0.2369; > 20 years to < 45 years vs > 40 years, P = 0.0001). (FIG. 2 B: < 20 years vs > 20 years to < 45 years, P = 0.7119; < 20 years vs > 40 years, P = 0.0001; > 20 years to < 45 years vs > 40 years, P = 0.0001).

Endocrine Abstracts

P1799