The 2015 American Thyroid Association guidelines and trends in hemithyroidectomy utilization for pediatric thyroid cancer
Eli Stein BS
Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Search for more papers by this authorMehul V. Raval MD, MS
Surgical Outcomes Quality Improvement Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois, USA
Search for more papers by this authorInbal Hazkani MD
Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Division of Pediatric Otolaryngology – Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
Search for more papers by this authorAudra Reiter MD, MPH
Surgical Outcomes Quality Improvement Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois, USA
Search for more papers by this authorJami L. Josefson MD
Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
Search for more papers by this authorJill H. Samis MD
Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
Search for more papers by this authorCorresponding Author
Jeffrey C. Rastatter MD, MS
Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Division of Pediatric Otolaryngology – Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
Correspondence
Jeffrey C. Rastatter, Department of Otolaryngology – Head and Neck Surgery, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave, Box 25, Chicago, IL 60611, USA.
Email: [email protected]
Search for more papers by this authorEli Stein BS
Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Search for more papers by this authorMehul V. Raval MD, MS
Surgical Outcomes Quality Improvement Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois, USA
Search for more papers by this authorInbal Hazkani MD
Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Division of Pediatric Otolaryngology – Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
Search for more papers by this authorAudra Reiter MD, MPH
Surgical Outcomes Quality Improvement Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital, Chicago, Illinois, USA
Search for more papers by this authorJami L. Josefson MD
Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
Search for more papers by this authorJill H. Samis MD
Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
Search for more papers by this authorCorresponding Author
Jeffrey C. Rastatter MD, MS
Department of Otolaryngology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Division of Pediatric Otolaryngology – Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
Correspondence
Jeffrey C. Rastatter, Department of Otolaryngology – Head and Neck Surgery, Northwestern University Feinberg School of Medicine, 225 E. Chicago Ave, Box 25, Chicago, IL 60611, USA.
Email: [email protected]
Search for more papers by this authorAbstract
Background
In 2015, the American Thyroid Association (ATA) released its inaugural recommendations for the management of thyroid cancer in children. We aim to evaluate whether there has been a change in hemithyroidectomy utilization for pediatric differentiated thyroid cancer, and the association between those changes and the release of the ATA guidelines.
Methods
The National Cancer Database was queried and identified 4776 patients ≤18 years old with differentiated thyroid cancer. Causal impact time-series analysis and logistic analysis were utilized to assess factors associated with use of hemithyroidectomy.
Results
Post-2015 hemithyroidectomy rate was greater than predicted based on preguideline trends (predicted: 8.4%, actual: 12.6%, p = 0.001). In logistic analysis of factors associated with hemithyroidectomy use, we find that Papillary histology, tumor size >1 cm, nodal examination, and positive nodes were associated with lower rate of hemithyroidectomy (OR: 0.23, 0.51, 0.62, and 0.18, respectively).
Conclusion
There has been a significant increase in hemithyroidectomy utilization for pediatric differentiated thyroid cancer.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from the National Cancer Database (NCDB)-jointly sponsored by the American College of Surgeons and the American Cancer Society. Restrictions apply to the availability of these data, which is used under the Business Associate Agreement that each CoC-accredited program has signed with the American College of Surgeons. NCDB Participant Use Files are available through an application process to investigators associated with CoC-accredited cancer programs.
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