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Pediatric thyroid cancer: An update from the SEER database
2007e2012*
Sarah Dermody a, *, Andrew Walls c, Earl H. Harley Jr. a, b
a Georgetown University School of Medicine, Washington, DC, 20007, USA
b Department of Otolaryngology e Head & Neck Surgery, Georgetown University Hospital, Washington, DC, 20007, USA
c Department of Surgery Division of Otolaryngology, Yale New Haven Hospital, New Haven, CT, 06510, USA
a r t i c l e i n f o
Article history:
Received 14 June 2016
Received in revised form
5 August 2016
Accepted 5 August 2016
Available online 8 August 2016
Keywords:
Otolaryngology
Pediatrics
Head and neck surgery
Thyroid cancer
a b s t r a c t
Objective: To update the medical literature regarding the incidence, disease specific survival, and
treatment modalities utilized in pediatric patients diagnosed with thyroid carcinomas.
Study design: Cross Sectional Analysis of a National Database.
Study setting: SEER Database.
Methods: The National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Database
was queried for all cases of pediatric thyroid cancer between the years 2007 and 2012. Patients ages 0
e19 were grouped by histological subtypes and demographic data, overall incidence rate, and disease
specific survival after surgery and surgery with radiation therapy. Fifteen-Year Disease Specific Survival
Curves were generated and treatment modalities were compared to assess for statistical differences at
each yearly interval.
Results: A total of 1723 pediatric patients were identified and the average age-adjusted rate of malig-
nancy was determined to be 0.59 per 100,000 patients. The incidence of pediatric thyroid cancer was
approximately 4.4:1 when comparing females to males, respectively. Papillary subtype was the most
common (n ¼ 1014, 58.8%), followed by follicular variant subtype (n ¼ 397, 23%), follicular subtype
(n ¼ 173, 10.1%) and medullary subtype (n ¼ 139, 8.1%). As pediatric patients reached fifteen to nineteen
years of age, the incidence of papillary and follicular variant subtypes increased. Analysis of medullary
thyroid cancer data revealed that incidence was highest in the zero to four age group and declined at
later years. Pediatric patients presenting with metastatic medullary thyroid carcinoma maintained
significantly poorer fifteen-year disease specific survival when compared to other histologic subtypes
(p < 0.05). Intervention with surgery and radiation therapy provided significant benefit across all his-
tologic subtypes when evaluating disease speci fic survival at fi fteen-years past the initial diagnoses
(p < 0.05).
Conclusions: Pediatric thyroid carcinoma remains an uncommon diagnosis despite an annual increase in
incidence of approximately one percent since the development of the SEER database. Overall, pediatric
thyroid carcinomas demonstrate an excellent prognosis if identified early and appropriate management
is available. Caucasian female patients have higher incidence of carcinoma diagnoses when compared to
males. Medullary histologic subtype, especially when metastatic at initial diagnoses, demonstrates sta-
tistically poorer outcomes when compared to other subtypes.
© 2016 Elsevier Ireland Ltd. All rights reserved.
1. Introduction
Thyroid cancer is a relatively uncommon pediatric diagnosis, yet
previous analyses have revealed that the incidence rate is
increasing at a rate of approximately one percent annually [1,2].
Recent studies have characterized thyroid malignancies as the third
* This manuscript was presented as an oral presentation at the American Society of Pediatric Otolaryngology 2016 Spring Meeting in Chicago, IL on May 20th.
* Corresponding author. Georgetown University School of Medicine, 3900 Reservoir Road, NW, Washington, DC, 20007, USA.
E-mail address: (S. Dermody).
Contents lists available at ScienceDirect
International Journal of Pediatric Otorhinolaryngology
journal homepage:
0165-5876/© 2016 Elsevier Ireland Ltd. All rights reserved.
International Journal of Pediatric Otorhinolaryngology 89 (2016) 121e126
Reprinted by permission of Int J Pediatr Otorhinolaryngol. 2016; 89:121-126.
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