Pediatric Thyroid Cancer Multidisciplinary Team Improves Adherence of Radioactive Iodine Treatment According to National Guidelines.

OBJECTIVE

To evaluate whether a multidisciplinary team (MDT) approach improves adherence to the 2015 American Thyroid Association (ATA) postoperative surveillance guidelines in pediatric thyroid cancer patients.

METHODS

A retrospective review at our institution was performed on pediatric patients who had thyroidectomy for papillary or follicular thyroid cancer between 2017 and 2024. Patients who were treated from 2017 to 2020 (pre-MDT) were compared to those treated from 2021 to 2024 (post-MDT), following the establishment of the MDT in January 2021. Data collected included timing of postoperative thyroglobulin (Tg) tests, iodine-123 (123I) diagnostic scans, iodine-131 (131I) administration, and the number of endocrinologists involved in care.

RESULTS

From 2017 to 2024, 47 patients were identified (n = 28 from 2017 to 2020; n = 19 from 2021 to 2024). Median age was 15 years. 131I was administered in 47% of low-risk patients from 2017 to 2020 (n = 7/15) and in 0% of low-risk patients from 2021 to 2024 (n = 0/7) (P = .04) based on ATA guidelines. Between the two time periods, there was an increased percentage of patients who had postoperative Tg tests or 123I diagnostic scans according to the ATA guidelines.

DISCUSSION: There were significantly fewer low-risk patients who received 131I treatment in the 2021 to 2024 group compared to the 2017 to 2020 group. A greater proportion of patients received guideline-recommended postoperative test in the second time period. Introduction of the MDT and fewer endocrinologists involved in postoperative care of each patient from 2021 is associated with improved adherence to the ATA guidelines for pediatric thyroid cancer patients.

IMPLICATIONS FOR PRACTICE: Our study supports the importance of the MDT in the postoperative care of pediatric thyroid cancer patients.