An individualized approach to the child with thyroid cancer

Abstract

Children with differentiated thyroid cancer (DTC) often present with extensive disease that inclined clinicians in prior decades toward aggressive treatment including total thyroidectomy, radical neck dissection and universal prescription of radioactive iodine (RAI). Recent series with 40 years of follow-up have shown that fewer than 2% of children ultimately die from DTC, but they may have increased all-cause mortality from second malignancies that might be related to previous radiation exposure. In this article, we review data to support the notion that an individualized, risk-stratified approach to therapy should be used for children with DTC. Ideally this will provide aggressive therapy for those in whom aggressive treatment is warranted, but withhold aggressive and risk-associated therapy from those who are not likely to benefit.

Keywords::

• cancer
• child
• nodule
• radioactive iodine
• thyroid
• treatment

Financial & competing interests disclosure

The authors have no 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. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.