{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T12:41:22Z","timestamp":1787229682612,"version":"build-2736575974"},"reference-count":31,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T00:00:00Z","timestamp":1738886400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Differentiated thyroid cancer (DTC) in children and adolescents is a rare but significant malignancy, often presenting at more advanced stages compared to adults, although it is associated with favorable long-term outcomes. This study aimed to identify prognostic factors and perform risk stratification with the goal of identifying low-risk patients who would benefit from a less radical treatment approach. Methods: This retrospective cohort study included patients aged 21 years and younger with DTC treated at the Institute for Oncology and Radiology of Serbia between 1980 and 2024. Results: The study analyzed 99 patients (39 children, 60 adolescents) with a median follow-up of 15.6 years (range: 0.6\u201343.6 years). No significant differences in long-term outcomes were observed between children and adolescents. Multivariate regression analysis identified a total number of more than 10.5 positive lymph nodes and extrathyroidal tumor extension as independent predictors of adverse events and event-free interval (EFI). Using these prognostic factors, patients were stratified into three groups: low-risk (no risk factors), intermediate-risk (one of two risk factors), and high-risk (both risk factors). Statistically significant differences in EFI were observed among the three groups. Notably, none of the patients in the low-risk group had evidence of disease after treatment. Patients classified as having no evidence of disease after treatment demonstrated significantly better EFI compared to those with evidence of disease. Conclusions: Our findings highlight the importance of meticulous risk stratification in predicting long-term outcomes and might serve as a basis for developing personalized therapeutic strategies. Identifying low-risk patients who may benefit from a less aggressive treatment approach while ensuring optimal treatment and follow-up for high-risk patients remains a central objective in the modern management of DTC.<\/jats:p>","DOI":"10.3390\/diagnostics15040399","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T05:04:33Z","timestamp":1738904673000},"page":"399","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Differentiated Thyroid Cancer Long-Term Outcomes and Risk Stratification in Pediatric and Adolescent Patients: A 44-Year Retrospective Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8062-1250","authenticated-orcid":false,"given":"Marko","family":"Buta","sequence":"first","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia"},{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7179-5435","authenticated-orcid":false,"given":"Nada","family":"Santrac","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia"},{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5756-1587","authenticated-orcid":false,"given":"Merima","family":"Goran","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia"},{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Jeftic","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7105-9883","authenticated-orcid":false,"given":"Jovan","family":"Raketic","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nevena","family":"Savkovic","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2715-5878","authenticated-orcid":false,"given":"Saska","family":"Pavlovic","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3917-541X","authenticated-orcid":false,"given":"Milan","family":"Zegarac","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia"},{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neven","family":"Jokic","sequence":"additional","affiliation":[{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5933-9453","authenticated-orcid":false,"given":"Ana","family":"Cvetkovic","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia"},{"name":"Department of Anesthesiology, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Stojanovic","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia"},{"name":"Clinic for Endocrinology, Diabetes and Metabolic Diseases, University Clinical Center of Serbia, Dr Subotica 13, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9862-592X","authenticated-orcid":false,"given":"Ana","family":"Jotic","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia"},{"name":"Clinic for Otorhinolaryngology and Maxillofacial Surgery, University Clinical Center of Serbia, Pasterova 2, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dusica","family":"Gavrilovic","sequence":"additional","affiliation":[{"name":"Data Center, Institute of Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Markovic","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Belgrade, Dr Subotica 8, 11 000 Belgrade, Serbia"},{"name":"Surgical Oncology Clinic, Institute for Oncology and Radiology of Serbia, Pasterova 14, 11 000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3892\/ijo.2021.5193","article-title":"New insights into the management of differentiated thyroid carcinoma in children and adolescents (Review)","volume":"58","author":"Zanella","year":"2021","journal-title":"Int. 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Surg."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/4\/399\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:28:27Z","timestamp":1760027307000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/15\/4\/399"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,7]]},"references-count":31,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["diagnostics15040399"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics15040399","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,7]]}}}