TY - JOUR
T1 - Thyroid carcinoma after treatment for malignancies in childhood and adolescence
T2 - From diagnosis through follow-up
AU - Podda, Marta Giorgia
AU - Terenziani, Monica
AU - Gandola, Lorenza
AU - Collini, Paola
AU - Pizzi, Natalia
AU - Marchianò, Alfonso
AU - Morosi, Carlo
AU - Luksch, Roberto
AU - Ferrari, Andrea
AU - Casanova, Michela
AU - Spreafico, Filippo
AU - Polastri, Daniela
AU - Meazza, Cristina
AU - Catania, Serena
AU - Schiavello, Elisabetta
AU - Biassoni, Veronica
AU - Massimino, Maura
PY - 2014
Y1 - 2014
N2 - With improvements in the survival rates after childhood cancer, many clinicians have turned their attention to reporting on late effects, and how they might be prevented or treated. In childhood the thyroid gland is especially vulnerable to the carcinogenic action of ionizing radiation. This retrospective study focused on secondary thyroid cancers seen at our institution over more than 30 years (between 1980 and 2012) in patients treated for other malignancies in pediatric age. 36 patients were identified. In most cases, the primary cancer had been Hodgkin disease, and all the patients had been administered radiotherapy for their first malignancy. The secondary thyroid cancers were treated with total thyroidectomy in 27 cases (six with lymphadenectomy), and hemithyroidectomy in nine (one with lymphadenectomy). 12 Patients were also given radiometabolic therapy. All but two had TSH suppression therapy. The histological diagnoses were: 31 papillary and five follicular carcinomas. At 5 and 10 years, the OS was 100 and 95%, respectively, and the PFS was 96 and 83%. None of the patients died of their thyroid disease. Nodal involvement at onset was the only factor correlating with recurrence. Surgical sequelae only occurred in patients who underwent total thyroidectomy. Survival in these patients did not depend on the extent of surgery on the thyroid parenchyma. Our data confirm a good prognosis for secondary thyroid cancer, prompting us to encourage a minimalist approach to the treatment of these particular patients wherever possible.
AB - With improvements in the survival rates after childhood cancer, many clinicians have turned their attention to reporting on late effects, and how they might be prevented or treated. In childhood the thyroid gland is especially vulnerable to the carcinogenic action of ionizing radiation. This retrospective study focused on secondary thyroid cancers seen at our institution over more than 30 years (between 1980 and 2012) in patients treated for other malignancies in pediatric age. 36 patients were identified. In most cases, the primary cancer had been Hodgkin disease, and all the patients had been administered radiotherapy for their first malignancy. The secondary thyroid cancers were treated with total thyroidectomy in 27 cases (six with lymphadenectomy), and hemithyroidectomy in nine (one with lymphadenectomy). 12 Patients were also given radiometabolic therapy. All but two had TSH suppression therapy. The histological diagnoses were: 31 papillary and five follicular carcinomas. At 5 and 10 years, the OS was 100 and 95%, respectively, and the PFS was 96 and 83%. None of the patients died of their thyroid disease. Nodal involvement at onset was the only factor correlating with recurrence. Surgical sequelae only occurred in patients who underwent total thyroidectomy. Survival in these patients did not depend on the extent of surgery on the thyroid parenchyma. Our data confirm a good prognosis for secondary thyroid cancer, prompting us to encourage a minimalist approach to the treatment of these particular patients wherever possible.
KW - Adolescents
KW - Cancer
KW - Children
KW - Late effects
KW - Radio-induced cancer
KW - Secondary thyroid carcinoma
KW - Survivors
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U2 - 10.1007/s12032-014-0121-6
DO - 10.1007/s12032-014-0121-6
M3 - Article
C2 - 25015396
AN - SCOPUS:84903864752
VL - 31
JO - Medical Oncology
JF - Medical Oncology
SN - 1357-0560
IS - 8
M1 - 121
ER -