Evidence map›Paper›PMID 27129982›Full record

ArticleJournal of endocrinological investigation2016

Surgical management of papillary thyroid carcinoma in childhood and adolescence: an Italian multicenter study on 250 patients.

C Spinelli, S Strambi, L Rossi, S Bakkar, M Massimino, A Ferrari, P Collini, G Cecchetto, G Bisogno, A Inserra and 2 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of endocrinological investigation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

C SpinelliDivision of Surgery, Department of Surgical Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy. c.spinelli@dc.med.unipi.it.
S StrambiDivision of Surgery, Department of Surgical Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
L RossiDivision of Surgery, Department of Surgical Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
S BakkarDivision of Surgery, Department of Surgical Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.
M MassiminoPediatric Oncology Unit, Istituto Nazionale Tumori, University of Milan, Milan, Italy.
A FerrariPediatric Oncology Unit, Istituto Nazionale Tumori, University of Milan, Milan, Italy.
P ColliniDepartment of Diagnostic Pathology and Laboratory Medicine, Istituto Nazionale Tumori, University of Milan, Milan, Italy.
G CecchettoDepartment of Women's and Children's Health, Pediatric Surgery Unit, University Hospital of Padua, Padua, Italy.
G BisognoHematology-Oncology Division, Department of Pediatrics, Padova University Hospital of Padua, Padua, Italy.
A InserraDivision of Pediatric Surgery, Bambino Gesù Children's Hospital, Rome, Italy.
F BiancoFaculty of Mathematical, Physical and Natural Sciences, University of Pisa, Pisa, Italy.
P MiccoliDivision of Surgery, Department of Surgical Pathology, University of Pisa, Via Paradisa 2, 56124, Pisa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe extent of surgery for pediatric papillary thyroid carcinoma is debatable. The aim of this study was to evaluate the feasibility of offering pediatric patients a tailored surgical approach based on certain clinical features.

methodsA national multicenter retrospective review of 250 pediatric patients treated for papillary thyroid carcinoma in a 14-year period was performed. Outcomes of interest included tumor-related features, type of surgery, surgical morbidity, disease-free and overall survival rates. Recurrence was thoroughly analyzed with particular focus on how it correlated with certain patient- and tumor-related features.

resultsThe majority of patients (58.8 %) had tumors >2 cm in size. Nodal involvement occurred in 115/250 (46 %) patients and distant metastasis in 4 % (10/250). Total thyroidectomy and lobectomy were performed in 90.4 % (226/250) and 9.6 % (24/250) of patients, respectively. The overall rate of surgical complications was 20.8 % (52/250). These included transient and permanent hypoparathyroidism (13.6 and 4.4 %, respectively), and vocal fold palsy (2.8 %). All surgical complications occurred exclusively in the total thyroidectomy group. The rate of recurrent disease was 12 % (30/250) with the vast majority of recurrences (96.6 %) occurring in the total thyroidectomy group. The risk of recurrence correlated significantly with certain tumor-related features (size > 2 cm, multifocality, extrathyroidal invasion, nodal positivity, and distant metastasis). However, it did not correlate with the patient's age or sex. Overall survival was 100 %.

conclusionPediatric patients are likely to benefit from a tailored surgical strategy. Uniformly offering patients total thyroidectomy seems to be an overly radical approach.

Indexed as

ThyroidectomyAdolescentCarcinoma, PapillaryChildChild, PreschoolDisease ManagementFemaleHumansItalyMaleNeoplasm Recurrence, LocalRetrospective StudiesThyroid NeoplasmsConservative surgeryPapillary thyroid carcinomaPediatric thyroid cancerTotal thyroidectomy

Identifiers

PMID27129982

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.