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J.Jpn. Surg. Soc.. 124(1): 38-43, 2023


Feature topic

TREATMENT STRATEGY FOR THYROID CANCERS IN CHILDHOOD AND ADOLESCENCE

1) Department of Thyroid and Endocrinology, Fukushima Medical University School of Medicine, Fukushima, Japan
2) Department of Thyroid Treatment, Fukushima Medical University School of Medicine, Fukushima, Japan

Yoshiko Matsumoto1), Kohki Shio1), Satoshi Suzuki1), Hiroshi Mizunuma1), Fumihiko Furuya1), Shinichi Suzuki2)

Thyroid cancers in childhood and adolescence are rare compared with those in adulthood. By histological type, papillary thyroid carcinoma (PTC) comprises almost 90% of cases. After the Fukushima Daiichi Nuclear Power Plant accidents following the Great East Japan Earthquake on March 11, 2011, the Fukushima Health Management Survey was initiated. We outline surgical procedures for children and adolescents with thyroid cancers detected by thyroid ultrasound examination. Surgery is basically the initial treatment for thyroid cancer in children and adolescents as well as in adults. The therapeutic indications for low- and high-risk patients are similar to those for adults. For intermediate-risk patients, as long as the lesion is confined to the ipsilateral side, including benign lesions, hemithyroidectomy with lymph node dissection (D1-2) is performed in order to avoid total thyroidectomy as far as possible. In addition, for childhood and adolescent cases of super low-risk PTC (T1aN0M0), active surveillance is not recommended due to the lack of evidence, and watchful follow-up is required.


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