{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:53:25Z","timestamp":1789606405750,"version":"build-2803163510"},"reference-count":23,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Thyroid\u00ae"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Differentiated thyroid carcinoma (DTC) in pediatric patients has specific clinical, pathological, and molecular characteristics, making its management different from that of adults. Our study aimed to evaluate the outcome and factors associated with persistent disease in a large cohort of pediatric patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a multicenter retrospective cohort study, including patients aged \u226418 years, diagnosed with a DTC, since January 2000. Both biochemical (BIR) and structural (SIR) incomplete responses were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We included 538 patients, 401\/538 (74.5%) females, with a median age of 15 years (interquartile range [IQR] 13\u201317 years). Papillary thyroid cancer was the most prevalent histotype and 277\/530 (52.3%) had lymph node metastases at diagnosis. Vascular invasion and gross extrathyroidal extension (ETE) were reported in 133\/326 (40.8%) and 91\/533 (17.1%) of patients, respectively. T4 tumors represented 5% of the entire cohort. Radioactive iodine treatment (RAIT) was administered to 493\/533 (92.5%) patients, and among them 138\/493 (28%) received more than one RAIT cycle. After a median follow-up of 85 months (IQR 42\u2013126 months), 414\/538 patients (77%) had no evidence of disease and 124\/538 patients (23.0%) a disease persistence: BIR in 68\/538 patients (12.6%) and SIR in 56\/538 patients (10.4%). In a multivariable analysis, the features significantly associated with persistent disease (BIR or SIR) were gross ETE (odds ratio [OR] 2.81, confidence interval [CI] 1.49\u20135.32,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0015) and lymph node uptake at whole-body scan (WBS) after the first RAIT (OR 3.31, CI 1.77\u20136.19,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0002). Multivariable analysis showed that the features significantly associated with SIR were T4 tumor (OR 4.3, CI 1.38\u201313.44,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.01) and lymph node uptake at WBS after the first RAIT (OR 3.39, CI 1.5\u20137.67,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Our study of a very large series of pediatric DTC with long follow-up provides valuable insights into the clinical and pathological features associated with disease persistence. We identified T4 tumor, lymph node uptake on WBS, and gross ETE as independent factors associated with persistent disease. These findings emphasize the importance of careful risk stratification in pediatric DTC, allowing for more individualized treatment approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10507256251363978","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T14:43:11Z","timestamp":1757688191000},"page":"1013-1023","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical and Pathological Factors Associated with Disease Persistence in Pediatric Patients with Differentiated Thyroid Carcinoma"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1534-8216","authenticated-orcid":false,"given":"Simone","family":"De Leo","sequence":"first","affiliation":[{"name":"Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Bottici","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Pellegriti","sequence":"additional","affiliation":[{"name":"Endocrinology Division, Garibaldi Nesima Hospital, Catania, Italy."},{"name":"Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Russo","sequence":"additional","affiliation":[{"name":"Endocrinology Division, Garibaldi Nesima Hospital, Catania, Italy."},{"name":"Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2615-8001","authenticated-orcid":false,"given":"Caterina","family":"Mian","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Department of Medicine (DIMED), University of Padua, Padova, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Vianello","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy, Istituto Oncologico Veneto-IRCCS, Padua, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Puligheddu","sequence":"additional","affiliation":[{"name":"SCDU Endocrinology, Andrology and Metabolism, Humanitas Gradenigo Hospital, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerdi","family":"Tuli","sequence":"additional","affiliation":[{"name":"Department of Paediatric Endocrinology, Regina Margherita Children\u2019s Hospital, Turin, Italy."},{"name":"Department of Pediatrics, University of Turin, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Ortolano","sequence":"additional","affiliation":[{"name":"IRCCS Azienda Ospedaliera-Universitaria, UO Pediatria, Bologna, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Castagna","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Neuroscience, UOC Endocrinology, University of Siena, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Pozza","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome, Roma, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malgorzata Gabriela","family":"Wasniewska","sequence":"additional","affiliation":[{"name":"Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manlio","family":"Cabria","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, E.O. \u201cOspedali Galliera\u201d, Genoa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Rochira","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy."},{"name":"Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Brigante","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy."},{"name":"Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Felicetti","sequence":"additional","affiliation":[{"name":"Oncological Endocrinology Unit, AOU Citt\u00e0 della Salute e della Scienza of Turin, University of Turin, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Vigone","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Endocrine Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Zatelli","sequence":"additional","affiliation":[{"name":"Section of Endocrinology, Geriatrics and Internal Medicine, Dept of Medical Sciences, University of Ferrara, Ferrara, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo","family":"Esposito","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Dolci","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuela","family":"Arvat","sequence":"additional","affiliation":[{"name":"Oncological Endocrinology Unit, AOU Citt\u00e0 della Salute e della Scienza of Turin, University of Turin, Turin, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Giorgino","sequence":"additional","affiliation":[{"name":"Department of Precision and Regenerative Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Giachetti","sequence":"additional","affiliation":[{"name":"General Medicine Unit, Valdagno Hospital, Valdagno, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7551-1751","authenticated-orcid":false,"given":"Maria Laura","family":"Tanda","sequence":"additional","affiliation":[{"name":"Endocrine Unit- Department of Medicine and Surgery, University of Insubria, Varese, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Fugazzola","sequence":"additional","affiliation":[{"name":"Endocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy."},{"name":"Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5333-9257","authenticated-orcid":false,"given":"Rossella","family":"Elisei","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-022-04596-4"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32125"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2024.0109"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semnuclmed.2015.10.006"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.10410"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.2350\/15-07-1667-OA.1"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2019.00552"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-017-4279-x"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2022.101715"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2014.0460"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ-22-0146"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1530\/ETJ-22-0180"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-40618-3"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2016.0104"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1419141"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2013.28.5.693"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2017.0102"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2022.0098"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-14-0053"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-009-0364-0"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27226"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13153732"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-021-05586-8"}],"container-title":["Thyroid\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10507256251363978","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10507256251363978","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10507256251363978","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:55:45Z","timestamp":1777679745000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10507256251363978"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":23,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1177\/10507256251363978"],"URL":"https:\/\/doi.org\/10.1177\/10507256251363978","relation":{},"ISSN":["1050-7256","1557-9077"],"issn-type":[{"value":"1050-7256","type":"print"},{"value":"1557-9077","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]}}}