Radiation-induced papillary thyroid cancer: Is it a distinct clinical entity?

Lorenzo Bresciani, Ester Orlandi, Cesare Piazza

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of reviewTo present the current status of knowledge regarding radiation-induced papillary thyroid cancer (RIPTC), defining its epidemiologic, pathologic, and clinical characteristics, with ensuing possible therapeutic and prognostic consequences.Recent findingsCumulative evidence shows that RIPTC resembles sporadic papillary thyroid cancer (PTC) of comparable age, both in terms of clinical-pathological features and prognosis. Therefore, more aggressive treatment does not seem to be required when managing RIPTC as its prognosis is comparable to that of never-irradiated patients.SummaryRadiation exposure in childhood is a well-documented risk factor for development of PTC. Therefore, increased exposure to medical or environmental radiation may be in part responsible, along with increased screening, of the recent burgeoning incidence of PTC. A specific morphological and molecular portrait of RIPTC is unlikely to exist. The more aggressive histologic and clinical features initially reported in radiation-induced cases are consistent with the expectations in nonradiation-related PTC of a comparable age. Aggressive histology, nodal, and distant metastases correlate with early age at onset rather than with radiation exposure. Although relapses are frequent in children, long-term cancer-specific mortality is approximately 1%, lower than that observed for adults and comparable between irradiated and nonirradiated cohorts. RIPTC does not require more aggressive surgery or more adjuvant treatments, as prognosis is as good as that of sporadic PTC when matched for stage and treatment received.

Original languageEnglish
Pages (from-to)117-122
Number of pages6
JournalCurrent Opinion in Otolaryngology and Head and Neck Surgery
Volume27
Issue number2
DOIs
Publication statusPublished - Apr 1 2019

Keywords

  • oncologic outcomes
  • papillary thyroid cancer
  • radiation
  • radiotherapy
  • treatment

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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