Who leads, who treats, what dose? European paediatric differentiated thyroid carcinoma practice-an European Cooperative Study Group for Paediatric Rare Tumours survey.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kuhlen Michaela, Roganivic Jelena, Naviglio Samuele, Baecklund Fredrik, Bello Rachel, Ben-Ami Tal, Bergamaschi Luca, Bilic Ernest, Bien Ewa, Brito Manuel João, Castañeda Alicia, Cesen Mazic Maja, Dos Reis Farinha Nuno Jorge, Jovanovska Aleksandra, de Krijger Ronald, Debora de Pasquale Maria, Elisei Rossella, Grau Bolado Gema, Guillén Gabriela, Haissaguerre Magalie, Hartl Dana, Huerta-Aragonés Jorge, Krawczyk Malgorzata A, Lamartina Livia, Leite Filipa, Leite Valeriano, López Almaraz Ricardo, Manevska Nevena, Mansuy Ludovic, Miele Evelina, Naderi Elin Hallan, Nordmann Winther Thilde, Petit Isabelle Oliver, Özön Zeynep Alev, Podda Marta Giorgia, Pourtsidis Apostolos, Reguerre Yves, Sandström Maria, Schneider Dominik T, Ekinci Saniye, Suput Omladic Jasna, Sztangierska Beata, Verite Cecile, Waespe Nicolas, Wong Kee Howe, Yalcin Bilgehan, Abele Michael, Bisogno Gianni, Orbach Daniel, Brecht Ines B, Virgone Calogero, Redlich Antje
Аннотация
DESIGN: Cross-sectional, web-based survey of centres providing paediatric DTC care.
SETTING & PARTICIPANTS: One consolidated response per centre was requested from a clinician overseeing paediatric DTC. The instrument covered centre profile/multidisciplinary tumour (MDT) board organization; staging and guideline use; risk stratification and dynamic response; diagnostics; surgery/lymph node management; radioactive iodine therapy (RAIT) policy and activity selection; and thyroid-stimulating hormone targets, follow-up, shared-care/transition. Analyses were descriptive at centre level.
RESULTS: Forty-two centres from 18 countries participated in the survey. Response denominators varied by item. Among responding centres, ≈75% were university or academic hospitals, ≈70% used a paediatric age cut-off of ≤18 years, and ≈60% reported having a dedicated MDT board. Staging and guideline use were heterogeneous: centres most often reported mixed or centre-specific guidance, followed by the American Thyroid Association (ATA) 2015 guideline, national guidelines, and the European Thyroid Association (ETA) 2022 guideline. Dynamic response-to-therapy categories were commonly used. For unilateral presumed low-risk disease, hemithyroidectomy was the usual initial surgery in approximately two-thirds to three-quarters of centres, whereas total thyroidectomy was less common. For low-risk patients, RAIT policy were split between de-escalation and risk-adapted use. When administered, RAIT activity was determined using weight-based, dosimetric, or fixed empirical approaches. Country-level patterns suggested clustering around ETA-leaning, ATA-leaning, and national guideline frameworks.
CONCLUSIONS: Across Europe, centres broadly endorse risk-adapted care but diverge at key decision nodes-extent of surgery, formal risk framework, and RAIT in low-risk disease-reflecting guidance plurality and organizational context. Leveraging existing infrastructures offers pragmatic avenues to reduce unwarranted variation while generating paediatric-specific evidence to refine recommendations.