Risk prediction in children and adults less than 45 years old with papillary thyroid cancer

ABSTRACT

Introduction: The incidence of papillary thyroid cancer is increasing faster than any other cancer in young patients. The purpose of this review is to discuss the most recent determinants of risk of recurrence and compromised outcomes in this population.

Areas covered: This review discusses the most updated data on patient age, including children and young adults, extent of disease and subsequent dynamic staging over time, molecular markers for disease aggressiveness, adequacy of surgical resection and surgeon volume, and novel therapies for advanced non-resectable disease as predictors of patient outcomes.

Expert commentary: Young patients enjoy excellent outcomes, with long-term survivorship, but face higher risks of short-term complications and disease recurrence. Thoughtful evaluation of the extent of disease, tumor features associated with more aggressive behavior, the presence of locoregional or distant metastases, and an understanding of molecular changes in their tumors are important areas of consideration. High-volume surgeons should work collaboratively with endocrinologists, radiologists, and pathologists specializing in thyroid cancer to help patients achieve excellent outcomes. Emerging data challenging the status quo regarding the relative importance of patient age, tumor features, and dynamic risk-adjustment for overall prognosis of these patients will likely impact future care and staging systems.

KEYWORDS:

• Papillary thyroid cancer
• recurrence
• thyroid cancer staging
• mortality

Declaration of interest

JA Sosa is a member of the data monitoring committee of the Medullary Thyroid Cancer Consortium Registry supported by NovoNordisk, GlaxoSmithKline, Astra Zeneca, and Eli Lilly. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded.