Thyroid cancer in children of ukraine after the Chernobyl accident

The results of treatment of 330 children (< 14 years) and adolescents (15-1 8 years) with thyroid cancer who were operated on at the Institute of Endoc rinology after the Chernobyl accident in 1986 were analyzed. The number of young patients increased after 1986 (1981-1985, 9 cases; 1986-1990, 37 case s; 1991-1995, 177 cases; 1996-1998, 116 cases). Most of these children and adolescents were younger than 8 years at the time of the accident (84.2%). More than half of the children (58.1%) lived in areas receiving the highest radiation exposure. These thyroid cancers developed after a short latent p eriod, were more aggressive at presentation, and expressed regional (57.3%) or distant (14.5%) metastasis. Solid papillary cancers were present in 93. 1%. Coexisting thyroid conditions were common (thyroid hyperplasia, 25.1%; nodular goiter, 18.8%; chronic thyroiditis, 10.2%). Most patients were trea ted by total thyroidectomy with intraoperative visualization of recurrent l aryngeal nerves and parathyroid glands. When lymph node metastases were ide ntified, a modified neck dissection was performed. Such operations were don e in 277 (84.1%) patients. Postoperatively, the patients mere treated with radioiodine and thyroid-stimulating hormone suppressive therapy. Postoperat ive complications included recurrent nerve palsy in 12.3% and permanent hyp oparathyroidism in 6%. Operations for local recurrence of Cancer were perfo rmed in 2.8% cases and for regional metastasis in 4%. The general mortality was 1.8%. We anticipate that there will be more patients with thyroid canc er during the next few years. Therefore this high risk population for thyro id cancer must be carefully monitored and evaluated during the next several decades.