Differentiated thyroid cancer in people aged 85 and older

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.

Keywords: surgery; thyroid cancer; thyroidectomy; treatment.