Differentiated thyroid carcinoma in children: Late effects of treatment and pathophysiological background in the Netherlands.

Background of the study:

Differentiated thyroid carcinoma (DTC) during childhood is an uncommon disease. Children often present with a more advanced tumor stage and show higher recurrence rates compared to adults. Nevertheless, the prognosis of childhood-onset DTC is excellent. The treatment is comparable in children and adults. However, data about long-term effects of 131-I treatment, long-term TSH suppressive therapy and quality of life in pediatric DTC patients are limited. Furthermore, it is not known if there is a relation between the presence of somatic mutations like BRAF and RET/PTC and the clinical course in pediatric DTC patients outside the Chernobyl region. More knowledge on treatment related damage might result in recommendations regarding childhood tailored therapy. Knowledge about the predictive value of the presence of somatic mutations in thyroid tumors could support the choice of more patient tailored treatment.



Objective of the study:

To study the late effects of 131-I treatment and TSH suppressive therapy as well as quality of life in patients with childhood-onset DTC. In addition, the postoperative complications and the presence of somatic mutations and their relationship with clinical outcome will be assessed.



Study design:

Multicenter cross-sectional study.



Study population:

All patients with childhood-onset DTC (age <19 years) diagnosed between 1970 and 2013 and treated in the Netherlands. About 150 patients are expected to be included in this study.



Primary study parameters:

The incidence of late effects of 131-I treatment and TSH suppressive therapy.



Secundary study parameters:

Presence of somatic mutations and relation with clinical outcome.
miRNA (-146b, -181b, -21, -221, -222) expression profile.
Incidence of family members with non-medullary thyroid carcinoma.

Differentiated thyroid carcinoma (DTC) is rare during childhood. Children often present with a more advanced tumor stage compared to adults. Nevertheless, the prognosis is excellent. Data about long-term effects of treatment in pediatric DTC patients are limited. It is not known if there is a relation between the presence of somatic mutations and the clinical course in pediatric DTC patients outside the Chernobyl region. More knowledge on treatment related damage might result in recommendations regarding childhood tailored therapy. Knowledge about the predictive value of the presence of somatic mutations in thyroid tumors could support the choice of more patient tailored treatment.

N/A

N/A