Kastley Marvin1, Kourosh Parham2. 1. School of Medicine, University of Connecticut, Farmington, Connecticut. 2. Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut.
Abstract
OBJECTIVES: To describe the characteristics and treatment patterns of differentiated thyroid cancer in older adults. DESIGN: Retrospective cohort study. SETTING: The National Cancer Institute Surveillance, Epidemiology, and End Results database. PARTICIPANTS: Individuals age 85 and older with a primary thyroid cancer diagnosis of papillary or follicular histology diagnosed between 1988 and 2007 (N=424). MEASUREMENTS: Age, sex, histology, extent of disease, tumor size, treatment, type of surgery, cause of death, and length of survival. RESULTS: Tumor size and extent of disease were significantly related to cause of death (P=.02). Participants who did not have surgery were more likely to die of their thyroid cancer than of any other cause (P=.01), and whether a participant had surgery was significantly related to age (P=.002). Participants who had surgery had significantly longer survival than those who did not (P<.001). Type of surgery (P=.92) and adding radioactive iodine after surgery (P=.07) did not appear to influence length of survival. CONCLUSION: Although differentiated thyroid cancer is typically considered a relatively indolent disease, this is not the case in older adults. Surgery appears to reduce the likelihood of death from thyroid cancer in this population and confers a survival benefit. Type of surgery and adding radioactive iodine therapy do not seem to improve the survival benefit of surgical management.
OBJECTIVES: To describe the characteristics and treatment patterns of differentiated thyroid cancer in older adults. DESIGN: Retrospective cohort study. SETTING: The National Cancer Institute Surveillance, Epidemiology, and End Results database. PARTICIPANTS: Individuals age 85 and older with a primary thyroid cancer diagnosis of papillary or follicular histology diagnosed between 1988 and 2007 (N=424). MEASUREMENTS: Age, sex, histology, extent of disease, tumor size, treatment, type of surgery, cause of death, and length of survival. RESULTS:Tumor size and extent of disease were significantly related to cause of death (P=.02). Participants who did not have surgery were more likely to die of their thyroid cancer than of any other cause (P=.01), and whether a participant had surgery was significantly related to age (P=.002). Participants who had surgery had significantly longer survival than those who did not (P<.001). Type of surgery (P=.92) and adding radioactive iodine after surgery (P=.07) did not appear to influence length of survival. CONCLUSION: Although differentiated thyroid cancer is typically considered a relatively indolent disease, this is not the case in older adults. Surgery appears to reduce the likelihood of death from thyroid cancer in this population and confers a survival benefit. Type of surgery and adding radioactive iodine therapy do not seem to improve the survival benefit of surgical management.
Authors: Juan J Díez; Emma Anda; Victoria Alcazar; María L Isidro; Cristina Familiar; Miguel Paja; Patricia Rojas Marcos; Begoña Pérez-Corral; Elena Navarro; Ana R Romero-Lluch; Amelia Oleaga; María J Pamplona; José C Fernández-García; Ana Megía; Laura Manjón; Cecilia Sánchez-Ragnarsson; Pedro Iglesias; Julia Sastre Journal: Endocrine Date: 2022-05-18 Impact factor: 3.925