Pediatric thyroid cancer patients referred to high-volume facilities have improved short-term outcomes

• Published in: Surgery 2018-02, Vol.163 (2), p.361-366
• Main Authors: Youngwirth, Linda M., Adam, Mohamed A., Thomas, Samantha M., Roman, Sanziana A., Sosa, Julie A., Scheri, Randall P.
• Format: Article
• Language: English
• ISSN: 0039-6060; 1532-7361
• DOI: 10.1016/j.surg.2017.09.042

Thyroid cancer is the most common endocrine malignancy in children, albeit still rare. This study sought to measure the association between outcomes and case volume of the treatment facility for pediatric patients with thyroid cancer. The National Cancer Data Base (1998–2011) was queried for all pediatric patients (age ≤ 18 years) with thyroid cancer. Demographic, clinical, and pathologic features were evaluated for all patients. Case volume of the treating facility was defined as the number of pediatric thyroid cancer patients at that facility during the study period. Restricted cubic spline modeling was used to determine a volume threshold associated with decreased risk of 30-day readmission. Patients were assigned to volume groups based on this threshold. Logistic regression was utilized to estimate the effect of volume on 30-day readmission. In total, 4,466 patients met inclusion criteria. The majority were girls (79.1%), white (86.1%), and underwent total thyroidectomy (86.9%). Compared with patients treated at the low-volume facilities, those treated at the high-volume facilities were more likely to have medullary thyroid cancer (10.7% versus 3.7%) and undergo total thyroidectomy (90.8% versus 86.3%) (all P