{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:36:38Z","timestamp":1778823398380,"version":"3.51.4"},"reference-count":16,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T00:00:00Z","timestamp":1736985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Differentiated thyroid carcinoma (DTC) is the most common pediatric thyroid malignancy, with papillary thyroid carcinoma (PTC) representing 90% of the cases. In 2015, the American Thyroid Association (ATA) developed management guidelines for pediatric DTC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>Patients less than 21\u00a0years of age diagnosed with DTC between 2000 and 2015 at Texas Children's Hospital, Seattle Children's Hospital, Children's Healthcare of Atlanta, Children's Hospital Colorado, and Nationwide Children's Hospital were retrospectively analyzed to evaluate treatment practices before the implementation of the ATA guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 216 pediatric patients with DTC. A majority were female (76%) with a median age at diagnosis of 14.8\u00a0years. Neck swelling (56%) and palpable nodules (49%) were common presenting symptoms. Diagnostic evaluations typically included thyroid ultrasound, with common features being microcalcifications (47.7%) and hypoechogenicity (39.0%). Fine\u2010needle aspiration cytology confirmed diagnosis in 50.5%. The majority of patients underwent total thyroidectomy (78.7%) and lymph node dissection (75.5%). ATA risk stratification was low, intermediate, and high risk in 111 (51.4%), 29 (13.4%), and 76 patients (35.2%), respectively. Upfront radioactive iodine (RAI) was administered in 83%. At 1\u2010year follow\u2010up, 46% were disease\u2010free (66% low risk, 59% intermediate risk, and 13% high risk). The 5\u2010year progression\u2010free survival for low, intermediate, and high risk were 86%, 53%, and 43%, respectively. The disease\u2010related overall survival was 100%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Prior to the introduction of the ATA guidelines, a majority of patients underwent total thyroidectomy with lymph node dissection followed by RAI. Selective use of RAI for low\u2010risk disease as recommended in the current guidelines may be appropriate.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.31545","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T04:25:08Z","timestamp":1737087908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multicenter Retrospective Analysis of Pediatric Differentiated Thyroid Carcinoma: Treatment Practices and Outcomes Prior to Pediatric American Thyroid Association Guidelines Implementation"],"prefix":"10.1002","volume":"72","author":[{"given":"Priya","family":"Mahajan","sequence":"first","affiliation":[{"name":"Division of Hematology\/Oncology Department of Pediatrics, University of Washington Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Beth","family":"May","sequence":"additional","affiliation":[{"name":"Institute for Clinical and Translational Research Baylor College of Medicine  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meghan","family":"Shekar","sequence":"additional","affiliation":[{"name":"Section of Hematology\/Oncology Department of Pediatrics, Dana\u2010Farber Cancer Institute\/Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Werny","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Department of Pediatrics, University of Washington Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Briana C.","family":"Patterson","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine M.","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Endocrinology Department of Pediatrics, University of Colorado School of Medicine Children's Hospital Colorado  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6547-1220","authenticated-orcid":false,"given":"Jennifer H.","family":"Aldrink","sequence":"additional","affiliation":[{"name":"Division of Pediatric Surgery Department of Surgery, Nationwide Children's Hospital The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyle Z.","family":"Horvath","sequence":"additional","affiliation":[{"name":"Center for Surgical Outcomes Research Nationwide Children's Hospital  Columbus Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3602-1375","authenticated-orcid":false,"given":"Douglas S.","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Department of Pediatrics, University of Washington Seattle Children's Hospital  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6691-5380","authenticated-orcid":false,"given":"Thomas A.","family":"Olson","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emory University School of Medicine, Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta  Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rajkumar","family":"Venkatramani","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology Department of Pediatrics, Baylor College of Medicine, Texas Children's Cancer 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