van de Berg Daniël J, Mooij Christiaan F, van Trotsenburg A S Paul, van Santen Hanneke M, Terwisscha van Scheltinga Sheila C E J, Vriens Menno R, Kruijff Schelto, Nieveen van Dijkum Els J M, Engelsman Anton F, Derikx Joep P M
Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
Department of Pediatric Endocrinology, Emma Children's Hospital, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
World J Surg. 2025 Jan;49(1):98-105. doi: 10.1002/wjs.12279. Epub 2024 Jul 7.
Follicular thyroid carcinoma (FTC) in adolescents and young adults (AYAs) is rare and data on long-term oncological outcomes are scarce. This study aimed to describe the long-term recurrence and survival rates of AYAs with FTC, and identify risk factors for recurrence.
This is a retrospective cohort study combining two national databases, including all patients aged 15-39 years, diagnosed with FTC in The Netherlands between 2000 and 2016. Age, sex, tumor size, focality, positive margins, angioinvasion, pT-stage, and pN-stage were included in a Cox proportional hazard model to identify risk factors for recurrence.
We included 192 patients. Median age was 31.0 years (IQR 24.7-36.3) and the male to female ratio was 1:4.1. Most patients presented with a minimally invasive FTC (MI-FTC) (95%). Five patients presented with synchronous metastases (2.6%), including two with locoregional metastases (1%) and three with distant metastases (1.6%). During a median follow-up of 12.0 years, three patients developed a recurrence (1.6%), of which one patient developed a local recurrence (33%), and two patients a distant recurrence (67%). Five patients died during follow-up (2.6%). Cause of death was not captured. A Cox proportional hazard model could not be performed due to the low number of recurrences.
FTC in AYAs is generally characterized as a low-risk tumor, as it exhibits a very low recurrence rate, a high overall survival, and it typically presents as MI-FTC without synchronous metastases. These findings underscore the favorable long-term oncological prognosis of FTC in AYAs.
青少年和年轻成人（AYA）的滤泡性甲状腺癌（FTC）较为罕见，关于长期肿瘤学结局的数据也很稀少。本研究旨在描述AYA患者FTC的长期复发率和生存率，并确定复发的危险因素。
这是一项回顾性队列研究，结合了两个国家数据库，纳入了2000年至2016年期间在荷兰诊断为FTC的所有15至39岁患者。将年龄、性别、肿瘤大小、病灶范围、切缘阳性、血管侵犯、pT分期和pN分期纳入Cox比例风险模型，以确定复发的危险因素。
我们纳入了192例患者。中位年龄为31.0岁（四分位间距24.7 - 36.3），男女比例为1:4.1。大多数患者表现为微小浸润性FTC（MI - FTC）（95%）。5例患者出现同步转移（2.6%），其中2例为局部区域转移（1%），3例为远处转移（1.6%）。在中位随访12.0年期间，3例患者出现复发（1.6%），其中1例出现局部复发（33%），2例出现远处复发（67%）。5例患者在随访期间死亡（2.6%）。死亡原因未记录。由于复发例数较少，无法进行Cox比例风险模型分析。
AYA患者的FTC通常具有低风险肿瘤的特征，因为其复发率极低、总生存率高，且通常表现为无同步转移的MI - FTC。这些发现强调了AYA患者FTC良好的长期肿瘤学预后。
