CLINICAL
USEFULNESS OF RISK STRATIFICATION OF CHILDREN WITH DIFFERENTIATED THYROID
CANCER
In addition
to its obvious prognostic value, risk stratification of children with differentiated
thyroid cancer (DTC) has important clinical implications regarding selection of
optimal treatment. Despite having an excellent prognosis, the risk of death
after many decades in children treated with postoperative radioiodine ablation therapy
(RIA) is higher than predicted, due to the development of second primary
malignancies (mainly cancer of the salivary glands and leukemia). In a study,
two thirds of the deaths resulted from these non-thyroidal malignancies during
a long-term follow-up (30 – 50 yrs)(*). Three quarters of these patients had
received postoperative therapeutic irradiation. This emphasizes the importance
of careful selection of pediatric patients for postoperative radioiodine (ablation)
therapy. Postoperative radioiodine ablation therapy is not indicated in
low-risk pediatric patients with DTC.
*Hay ID,
World J Surg 2010, 34:1192
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