Long‐term results in elderly patients with differentiated thyroid carcinoma

Abstract

BACKGROUNDThe authors assessed the biologic behavior of differentiated thyroid carcinoma in patients age 70 years or older and evaluated factors that influenced long‐term survival.METHODSAmong 1448 patients with differentiated thyroid carcinoma who were treated at the authors' institution over the past 60 years, 111 patients were identified who were age 70 years or older at the time of their initial diagnosis (range, 70–93 years). The authors conducted a retrospective analysis of the outcome of these 111 patients, who had a median follow‐up of 9 years (range, 2–9 years).RESULTSThere were 83 female patients and 28 male patients (female to male ratio, 3:1). Fifty‐eight tumors were papillary, 46 tumors were follicular, and 7 tumors were Hürthle cell carcinoma. Eighty percent of patients presented with a thyroid mass, and 70% of tumors were pathologic stage T3 (pT3) or pT4. Lymph node disease was evident at presentation in 44% of patients, and distant metastases were documented at diagnosis in 23% of patients. Forty‐six patients underwent total thyroidectomy, and the remaining patients underwent subtotal thyroidectomy or biopsy only. Radioiodine was administered to 80 patients, and external beam radiotherapy was administered to 19 patients. The cause specific survival rates were 75%, 50%, and 50% at 5 years, 10 years, and 15 years, respectively. Multivariate analysis showed that the presence of metastases was the most important independent prognostic factor for survival. External beam radiotherapy was associated with a poorer prognosis, in that it was reserved for patients with either inoperable disease or residual disease after surgery and patients with no uptake of radioiodine.CONCLUSIONSA large proportion of thyroid tumors showed extrathyroid spread and distant metastases, which frequently were not iodine‐avid. The prevalent histologic type was papillary, often with features of poor differentiation. Thyroid carcinoma in the elderly appears to behave more aggressively, and they have a less favorable prognosis compared with younger adults. Cancer 2003;97:2736–42. © 2003 American Cancer Society.DOI 10.1002/cncr.11410

Could Tumor Size Be A Predictor for Papillary Thyroid Microcarcinoma: a Retrospective Cohort Study

“…However, other studies demonstrated that the risk of recurrence significantly increased in PTMC patients with CLNM (Chow et al, 2003). In addition, some investigators have showed that the operations for recurred lymph nodes in PTC increased the risk of postoperative complications (Vini et al, 2003) . Furthermore, CLND is helpful to assess the accurate staging of lymph node (Levin et al, 1992).…”

Clinicopathologic Characteristics and Surgical Outcomes of Elderly Patients with Thyroid Cancer

“…Younger group were ,70 years of age. The cutoff of age groups is based on that was used in the previous studies (3,4). Their clinicopathologic and molecular features were analyzed.…”

“…The American Joint Committee on Cancer has defined a staging system for differentiated thyroid carcinoma according to age. Elderly patients who have a short life expectancy also present with poor prognostic factors including advanced stage, lymph node metastasis and distant metastasis, as compared with younger patients (3).…”

Papillary Thyroid Microcarcinoma - Do Classical Staging Systems Need to Be Changed?

“…Moreover, few reports specifically analyze the behavior of thyroid cancer in the elderly. Vini et al [2003] studied the biological behavior in 111 patients with DTC, who were older than 70. The authors found that older age was an important risk factor for overall survival.…”

“…Furthermore, investigators showed that the probability of survival changed significantly according to the decade in which the patient was treated. Thus, median survival improved from 4.7 years before 1970, to more than 10 years after 1990 [Vini et al, 2003]. J.…”