EXTENT OF LYMPH NODE METASTASES AND ITS IMPACT ON OUTCOME IN PEDIATRIC THYROID CANCER PATIENTS anjali@sgpgi.ac.in

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EXTENT OF LYMPH NODE METASTASES AND ITS IMPACT ON OUTCOME IN PEDIATRIC THYROID CANCER PATIENTS

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India

Oral or Poster

Presence of lymph node metastases (LNM) could influence clinical outcome in pediatric thyroid cancer (TC) patients. The aim of this study was to investigate the extent and distribution of LNM and its effect on overall survival (OS) and recurrence free survival (RFS) in pediatric TC patients.

Retrospective study (January 1990 to December 2024) of 68 pediatric TC patients (< 18 years) excluding meduallary thyroid carcinoma. Clinicopathological details, OS and RFS were analyzed.

Mean age of the cohort was 15.4 years (M:F= 1:1.3). Eighty-seven percent had papillary carcinoma 11.8 follicular and 1.5% poorly differentiated carcinoma. Median Tumor size was 2.8 cm. Tumor multicentricity (MC), extrathyroidal invasion (EI), LNM, and distant metastases (DM) were noted in 38.3, 25, 67.6 and 14.7% respectively. Total thyroidectomy was performed in 95% and 65% received radioiodine ablation/therapy. Central compartment dissection was performed in 76.5 % and 58.8 % children in addition had lateral neck dissection (bilateral= 33.8%). Median number of LN dissected, LNM and lymph node ratio was 33 (IQR: 12-47), 10 (IQR: 6-21) and 0.40 (IQR: 0.21- 0.61) respectively. Twenty-six percent patients with LNM showed extra-nodal extension. Five and ten- years OS was 93.3 and 88.1% whereas RFS was 66.6 and 62.4% respectively. On univariate analysis OS was significantly associated with DM (p=0.001), EI (P=0.006), MC (p=0.020), and LNM compartments (p=0.025). RFS was significantly associated with sex (p=0.031), LNM (p=0.037) and LNM compartments (p=0.002).

Extent of LNM seems to have significant impact on OS and RFS in pediatric TC patients.