ArticleJournal of the Endocrine Society2026
Age stratifies disease extent in pediatric and young adult fusion-positive papillary thyroid carcinoma.
Article in Journal of the Endocrine Society, 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
Context: Fusion-positive pediatric papillary thyroid carcinoma (PTC) often presents with regional nodal or distant disease, but factors explaining heterogeneity within fusion-positive tumors are incompletely defined. Objective: To determine whether age, fusion group, or sex is associated with baseline N1b and/or M1 disease in fusion-positive pediatric and young adult PTC. Design: Retrospective analysis of the international PEDIMAP cohort. Setting: Multi-institutional pediatric and young adult thyroid carcinoma cohort. Patients: Patients aged 0-25 years with PTC, documented somatic kinase fusion, and available fusion-partner information. Interventions: None. Main Outcome Measures: Advanced baseline presentation, defined as AJCC N1b and/or M1 disease. Associations were tested using Firth penalized logistic regression. Results: Of 101 kinase fusion-positive PTCs identified among 646 PTCs, 2 rearranged during transfection (RET)-fusion cases were excluded because fusion-partner information was unavailable, yielding 99 fusion-positive tumors with known fusion partners: RET, n = 52; neurotrophic receptor tyrosine kinase (NTRK), n = 28; and other non-RET/NTRK kinase fusions, n = 19. Among 95 patients with evaluable N- and M-stage, 64 (67.4%) had N1b and/or M1 disease. Age 0-14 years was associated with higher odds of advanced presentation than age 15-25 years (adjusted OR, 4.67; 95% CI, 1.84-12.75; Conclusion: Within fusion-positive pediatric and young adult PTC, younger age was associated with greater baseline disease extent, whereas no significant difference in N1b/M1 presentation was found between
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