Who Leads, Who Treats, What Dose? European Paediatric DTC Practice - an EXPeRT survey.
Publisher DOI
PubMed ID
42139545
Abstract
Objective
To map real-world management of paediatric differentiated thyroid carcinoma (DTC) across Europe and identify targets for harmonisation.Design
Cross-sectional, web-based survey of centres providing paediatric DTC care.Methods
One consolidated response per centre was requested from a clinician overseeing paediatric DTC. The instrument covered centre profile/multidisciplinary tumour board organisation; staging and guideline use; risk stratification and dynamic response; diagnostics; surgery/lymph node management; radioiodine therapy (RAIT) policy and activity selection; Thyroid-Stimulating Hormone targets, follow-up, shared-care/transition. Analyses were descriptive at centre level.Results
Forty-two centres from 18 countries participated. Among centres answering each item, university/academic hospitals ≈75%; paediatric age cut-off ≤18 y ≈70%; dedicated multidisciplinary tumour board (MDT) ≈60%. Staging systems varied and the primary guidance was mixed (∼30%), American Thyroid Association (ATA) 2015 (∼25-30%), national (∼20-25%), or European Thyroid Association (ETA) 2022 (∼10-15%). Dynamic response-to-therapy categories were commonly used. For unilateral presumed low-risk disease, hemithyroidectomy was the usual initial surgery in about two-thirds to three-quarters of centres, total thyroidectomy was less frequent. For low-risk patients, RAIT policy split between de-escalation (≈55%) and risk-adapted use (≈45%). When given, activity was determined by weight, dosimetry, or fixed empiric approaches. Country-level patterns were evident (ETA- vs ATA-leaning/national environments).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 organisational context. Leveraging existing infrastructures offers pragmatic avenues to reduce unwarranted variation while generating paediatric-specific evidence to refine recommendations.
To map real-world management of paediatric differentiated thyroid carcinoma (DTC) across Europe and identify targets for harmonisation.Design
Cross-sectional, web-based survey of centres providing paediatric DTC care.Methods
One consolidated response per centre was requested from a clinician overseeing paediatric DTC. The instrument covered centre profile/multidisciplinary tumour board organisation; staging and guideline use; risk stratification and dynamic response; diagnostics; surgery/lymph node management; radioiodine therapy (RAIT) policy and activity selection; Thyroid-Stimulating Hormone targets, follow-up, shared-care/transition. Analyses were descriptive at centre level.Results
Forty-two centres from 18 countries participated. Among centres answering each item, university/academic hospitals ≈75%; paediatric age cut-off ≤18 y ≈70%; dedicated multidisciplinary tumour board (MDT) ≈60%. Staging systems varied and the primary guidance was mixed (∼30%), American Thyroid Association (ATA) 2015 (∼25-30%), national (∼20-25%), or European Thyroid Association (ETA) 2022 (∼10-15%). Dynamic response-to-therapy categories were commonly used. For unilateral presumed low-risk disease, hemithyroidectomy was the usual initial surgery in about two-thirds to three-quarters of centres, total thyroidectomy was less frequent. For low-risk patients, RAIT policy split between de-escalation (≈55%) and risk-adapted use (≈45%). When given, activity was determined by weight, dosimetry, or fixed empiric approaches. Country-level patterns were evident (ETA- vs ATA-leaning/national environments).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 organisational context. Leveraging existing infrastructures offers pragmatic avenues to reduce unwarranted variation while generating paediatric-specific evidence to refine recommendations.
Date Issued
2026-06-01
Publication Type
Article
Subject(s)
Subjects
EXPeRT
•
European practice
•
differentiated thyroid carcinoma
•
paediatric
•
survey
Language(s)
en
Author(s)
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 | |
Schneider, Dominik T | |
Ekinci, Saniye | |
Suput Omladic, Jasna | |
Sztangierska, Beata | |
Verite, Cecile | |
Wong, Kee Howe | |
Yalcin, Bilgehan | |
Abele, Michael | |
Bisogno, Gianni | |
Orbach, Daniel | |
Brecht, Ines B | |
Virgone, Calogero | |
Redlich, Antje |
Additional Credits
Journal
European journal of endocrinology
Publisher
Oxford University Press
ISSN
1479-683X
0804-4643
Access(Rights)
open.access