Abstract：
OBJECTIVE: To provide a clinical disease state review of recent relevant literature and to generate expert consensus statements regarding the breadth of pediatric thyroid cancer diagnosis and care, with an emphasis on thyroid surgery. To generate expert statements to educate pediatric practitioners on the state-of-the-art practices and the value of surgical experience in the management of this unusual and challenging disease in children.
METHODS: A literature search was conducted and statements were constructed and subjected to a modified Delphi process to measure the consensus of the expert author panel. The wording of statements, voting tabulation, and statistical analysis were overseen by a Delphi expert (J.J.S.).
RESULTS: Twenty-five consensus statements were created and subjected to a modified Delphi analysis to measure the strength of consensus of the expert author panel. All statements reached a level of consensus, and the majority of statements reached the highest level of consensus.
CONCLUSIONS: Pediatric thyroid cancer has many unique nuances, such as bulky cervical adenopathy on presentation, an increased incidence of diffuse sclerosing variant, and a longer potential lifespan to endure potential complications from treatment. Complications can be a burden to parents and patients alike. We suggest that optimal outcomes and decreased morbidity will come from the use of advanced imaging, diagnostic testing, and neural monitoring of patients treated at high-volume centers by high-volume surgeons.
METHODS: A literature search was conducted and statements were constructed and subjected to a modified Delphi process to measure the consensus of the expert author panel. The wording of statements, voting tabulation, and statistical analysis were overseen by a Delphi expert (J.J.S.).
RESULTS: Twenty-five consensus statements were created and subjected to a modified Delphi analysis to measure the strength of consensus of the expert author panel. All statements reached a level of consensus, and the majority of statements reached the highest level of consensus.
CONCLUSIONS: Pediatric thyroid cancer has many unique nuances, such as bulky cervical adenopathy on presentation, an increased incidence of diffuse sclerosing variant, and a longer potential lifespan to endure potential complications from treatment. Complications can be a burden to parents and patients alike. We suggest that optimal outcomes and decreased morbidity will come from the use of advanced imaging, diagnostic testing, and neural monitoring of patients treated at high-volume centers by high-volume surgeons.
摘要：
目的：对近期相关文献进行临床疾病状态综述，并就小儿甲状腺癌诊断和治疗的广度提出专家共识声明，重点是甲状腺手术。生成专家陈述，以教育儿科从业人员了解最先进的做法以及手术经验在儿童这种不寻常且具有挑战性的疾病管理中的价值。
方法：进行了文献检索，并构建了陈述并进行了修改的Delphi过程，以衡量专家作者小组的共识。声明的措辞，投票制表，统计分析由德尔菲专家(J.J.S.)监督。
结果：创建了25个共识声明，并进行了改良的Delphi分析，以衡量专家作者小组的共识强度。所有声明都达成了共识，大多数声明达成了最高共识。
结论：小儿甲状腺癌有许多独特的细微差别，如大体积的宫颈腺病，弥漫性硬化变异的发生率增加，以及更长的潜在寿命来承受治疗带来的潜在并发症。并发症可能是父母和患者的负担。我们建议最佳的结果和降低的发病率将来自使用先进的成像，诊断测试,以及由高容量外科医生在高容量中心治疗的患者的神经监测。
方法：进行了文献检索，并构建了陈述并进行了修改的Delphi过程，以衡量专家作者小组的共识。声明的措辞，投票制表，统计分析由德尔菲专家(J.J.S.)监督。
结果：创建了25个共识声明，并进行了改良的Delphi分析，以衡量专家作者小组的共识强度。所有声明都达成了共识，大多数声明达成了最高共识。
结论：小儿甲状腺癌有许多独特的细微差别，如大体积的宫颈腺病，弥漫性硬化变异的发生率增加，以及更长的潜在寿命来承受治疗带来的潜在并发症。并发症可能是父母和患者的负担。我们建议最佳的结果和降低的发病率将来自使用先进的成像，诊断测试,以及由高容量外科医生在高容量中心治疗的患者的神经监测。
