ORIGINAL ARTICLE Therapeutic outcome and prognosis in young patients with papillary and follicular thyroid cancer Chung-Huei Huang • Tzu-Chieh Chao • Chuen Hseuh • Kun-Ju Lin • Tsung-Ying Ho • Shu-Fu Lin • Jen-Der Lin Accepted: 9 January 2012 / Published online: 25 January 2012 Ó Springer-Verlag 2012 Abstract Background Papillary and follicular thyroid cancer is a common malignancy in young patients, and the incidence of this cancer has been increasing. The aims of this study are to assess the clinical characteristics of papillary and follicular thyroid cancer in young patients and evaluate the long-term therapeutic outcomes and prognostic factors for cancer mortality and recurrence. Methods We performed a retrospective analysis of 116 patients aged B20 years who underwent thyroidectomy and a mean follow-up of 11.1 ± 0.6 years. Results There were 28 (24.1%) patients classified into the residual cancer or relapse groups. The progression-free survival rate for the young patients was lower than that of the patients between 20 and 45 years of age; however, the difference between the thyroid cancer survival rates was not statistically different. Two of the 28 patients died of thyroid cancer. Thirteen patients who showed relapsed underwent 131 I whole-body scan; 6 of the 13 patients were diagnosed with distant metastases to the lung and 1 was diagnosed with distant metastases to the bones. Among the young patients, the 5- and 10-year progression-free sur- vival rates were 79.1 and 73.4%, respectively, and the corresponding cancer survival rates were 99.1, and 96.5%, respectively. Conclusion The progression-free survival in young patients with papillary and follicular thyroid cancer was lower than the patients of age 20–45 years; otherwise, cancer survival was higher than age group over or equal to 45 years. Keywords Thyroglobulin Á 131 I therapy Á Cancer-related mortality Á Secondary primary cancer Introduction Papillary and follicular thyroid cancer is a common malignancy in patients younger than 20 years, and its incidence had been increasing [1–3]. As in most well-dif- ferentiated thyroid cancer patients, these patients are young and have rather good prognosis [4]. However, appropriate treatment and long-term follow-up are important to prevent delayed diagnosis and high rates of cancer recurrence [5, 6]. To avoid the complications and adverse effects of adjuvant therapies in young patients, conservative surgical procedures or postoperative therapeutic modalities have been recommended [7, 8]. Factors such as the dose of radioactive iodide ( 131 I) and difficulty in isolating young patients usually make therapeutic planning difficult [9, 10]. Furthermore, growth and development in young patients and pregnancy in the follow-up period usually interrupt the treatment schedule. The purpose of this retrospective study was to assess and compare the clinical characteristics of C.-H. Huang Á S.-F. Lin Á J.-D. Lin (&) Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Shin St., Taoyuan Hsien, Kweishan County, Taiwan, ROC e-mail: einjd@adm.cgmh.org.tw T.-C. Chao Department of General Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROC C. Hseuh Department of Pathology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROC K.-J. Lin Á T.-Y. Ho Department of Nuclear Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan Hsien, Taiwan, ROC 123 Pediatr Surg Int (2012) 28:489–494 DOI 10.1007/s00383-012-3054-1