ArticleEuropean thyroid journal2026
Risk stratification and long-term monitoring in pediatric thyroid cancer: predictive markers for disease persistence.
Article in European thyroid journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Initial risk stratification and dynamic risk stratification are crucial in managing pediatric differentiated thyroid carcinoma (DTC), aiming to guide treatment and long-term follow-up. While adult dynamic stratification is well established, pediatric data remain limited, and no formal recommendations exist for its use. Objective: To evaluate the prognostic value of early dynamic risk stratification (EDRS) and postoperative stimulated thyroglobulin (sPOTg) in predicting long-term outcomes in pediatric DTC and to compare EDRS with initial ATA pediatric risk stratification (IRS). Methods: We conducted a retrospective cohort study of 123 patients ≤18 years with DTC treated at a tertiary center. IRS and EDRS (1-3 years post-treatment) were compared to late dynamic response (LDRS, ≥10 years post-treatment). A total of 83 patients had complete long-term follow-up data. Associations were assessed using chi-square tests, logistic regression, Cohen's kappa, and Cramér's V. ROC curve analysis evaluated the predictive value of sPOTg. Results: Among 83 patients with ≥10 years of follow-up, EDRS showed a strong association with LDRS (Cramér's V = 0.829; P < 0.001), outperforming IRS (Cramér's V = 0.33; P = 0.0029). Concordance between EDRS and LDRS was substantial (kappa = 0.79). Stimulated postoperative thyroglobulin (sPOTg) showed good discriminatory performance for disease persistence, with AUCs of 0.84 (95% CI: 0.70-0.95) at 1-3 years and 0.81 at ≥10 years. Conclusion: Early dynamic response is a strong predictor of long-term outcomes and may surpass IRS in prognostic accuracy. sPOTg is a valuable biomarker for both early and late risk assessment. Prospective multicenter validation is warranted.
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