Department of Pediatric Endocrinology, Wilhelmina Children's Hospital (WKZ)/University Medical Center Utrecht (UMCU), Utrecht, The Netherlands.
Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Eur J Endocrinol. 2020 Oct;183(4):P11-P18. doi: 10.1530/EJE-20-0191.
Currently, there are no European recommendations for the management of pediatric thyroid cancer. Other current international guidelines are not completely concordant. In addition, medical regulations differ between, for instance, the US and Europe. We aimed to develop new, easily accessible national recommendations for differentiated thyroid carcinoma (DTC) patients <18 years of age in the Netherlands as a first step toward a harmonized European Recommendation.
A multidisciplinary working group was formed including pediatric and adult endocrinologists, a pediatric radiologist, a pathologist, endocrine surgeons, pediatric surgeons, pediatric oncologists, nuclear medicine physicians, a clinical geneticist and a patient representative. A systematic literature search was conducted for all existing guidelines and review articles for pediatric DTC from 2000 until February 2019. The Appraisal of Guidelines, Research and Evaluation (AGREE) instrument was used for assessing quality of the articles. All were compared to determine dis- and concordances. The American Thyroid Association (ATA) pediatric guideline 2015 was used as framework to develop specific Dutch recommendations. Discussion points based upon expert opinion and current treatment management of DTC in children in the Netherlands were identified and elaborated.
Based on the most recent evidence combined with expert opinion, a 2020 Dutch recommendation for pediatric DTC was written and published as an online interactive decision tree (www.oncoguide.nl).
Pediatric DTC requires a multidisciplinary approach. The 2020 Dutch Pediatric DTC Recommendation can be used as a starting point for the development of a collaborative European recommendation for treatment of pediatric DTC.
目前，欧洲尚无儿童甲状腺癌管理的相关推荐。其他现行国际指南并不完全一致。此外，美国和欧洲之间的医疗法规也存在差异。我们旨在为荷兰<18 岁的分化型甲状腺癌（DTC）患者制定新的、易于获取的国家推荐，作为制定协调一致的欧洲推荐的第一步。
成立了一个多学科工作组，成员包括儿科和成人内分泌学家、儿科放射科医生、病理学家、内分泌外科医生、小儿外科医生、小儿肿瘤学家、核医学医生、临床遗传学家和患者代表。对 2000 年至 2019 年 2 月期间所有关于儿科 DTC 的现有指南和综述文章进行了系统的文献检索。使用评估指南、研究和评价（AGREE）工具评估文章的质量。将所有文章进行比较，以确定差异和一致性。以美国甲状腺协会（ATA）2015 年儿科指南为框架，制定具体的荷兰推荐。根据专家意见和荷兰儿童 DTC 的当前治疗管理，确定并详细阐述了讨论要点。
根据最新证据并结合专家意见，撰写并发布了 2020 年荷兰儿科 DTC 推荐，作为在线交互式决策树（www.oncoguide.nl）。
儿科 DTC 需要多学科方法。2020 年荷兰儿科 DTC 推荐可作为制定协作性欧洲儿科 DTC 治疗推荐的起点。
