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Age-based disparities in the use of total thyroidectomy for papillary thyroid carcinoma

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Abstract

Background

Elderly patients may be less likely than younger patients to receive indicated therapy. We hypothesized that older patients with papillary thyroid carcinoma (PTC) would be less likely to receive total thyroidectomy (TT) than their younger counterparts.

Materials and methods

The Surveillance, Epidemiology, and End Results database were queried for adult patients diagnosed with PTC from 2000 through 2009. Patients were categorized according to whether they received a TT or less than a total thyroidectomy (<TT). We used multivariate logistic regression to predict the use of <TT. The likelihood of undergoing <TT was reported as odds ratios (OR) with 95% confidence intervals (CI).

Results

Of the 67,961 patients identified with PTC, 51,276 (75%) received TT, 14,750 (22%) <TT and 1935 (3%) no surgery. On multivariate analysis, advancing age increased the likelihood of receiving <TT (age 45–54 OR 1.15, CI [1.09–1.20]; age 55–64 OR 1.20, CI [1.14–1.26]; age 65–74 OR 1.40, CI [1.32–1.49]; 75–84 OR 1.80, CI [1.65–1.95]; ≥85 OR 3.01, CI [2.51–3.62], all p < 0.001).

Conclusions

Older patients with PTC are less likely to receive TT. Further research is needed to assess if older patients are negatively impacted by less complete surgery.

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References

  1. Siegel R, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66:7–30.

    Article  PubMed  Google Scholar 

  2. Cramer JD, Fu P, Harth KC, Margevicus S, Wilhelm SM. Analysis of the rising incidence of thyroid cancer using the Surveillance, Epidemiology and End Results national cancer data registry. Surgery. 2010;148:1147–52.

    Article  PubMed  Google Scholar 

  3. Bliss R, Patel N, Guinea A, Reeves TS, Delbridge L. Age is no contraindication to thyroid surgery. Age Ageing. 1999;28:363–6.

    Article  CAS  PubMed  Google Scholar 

  4. Biliotti GC, Martini F, Vezzosi V, Seghi P, Tozzi F, Castagnoli A, et al. Specific features of differentiated thyroid carcinoma in patients over 70 years of age. J Surg Oncol. 2006;93:194–8.

    Article  CAS  PubMed  Google Scholar 

  5. Falvo L, Catania A, D’Andrea V, Marzullo A, Giustiniani MC, De Antoni E. Prognostic significance of the age factor in the thyroid cancer: statistical analysis. J Surg Oncol. 2004;88:217–22.

    Article  PubMed  Google Scholar 

  6. Ito Y, Miyauchi A, Kihara M, Takamura Y, Kobayashi K, Miya A, et al. Relationship between prognosis of papillary thyroid carcinoma patient and age: a retrospective single-institution study. Endocr J. 2012;59:399–405.

    Article  PubMed  Google Scholar 

  7. Miccoli P, Minuto MN, Ugolini C, Panicucci E, Massi M, Berti P, et al. Papillary thyroid cancer: pathological parameters as prognostic factors in different classes of age. Otolaryngol Head Neck Surg. 2008;138:200–3.

    Article  PubMed  Google Scholar 

  8. Tran Cao HS, Johnston LE, Chang DC, Bouvet M. A critical analysis of the American Joint Committee on Cancer (AJCC) staging system for differentiated thyroid carcinoma in young patients on the basis of the Surveillance, Epidemiology, and End Results (SEER) registry. Surgery. 2012;152:145–51.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19:1167–214.

    Article  PubMed  Google Scholar 

  10. Cho JS, Yoon JH, Park MH, Shin SH, Jegal YJ, Lee JS, et al. Age and prognosis of papillary thyroid carcinoma: retrospective stratification into three groups. J Korean Surg Soc. 2012;83:259–66.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ito Y, Kudo T, Takamura Y, Kobayashi K, Miya A, Miyauchi A. Prognostic factors of papillary thyroid carcinoma vary according to sex and patient age. World J Surg. 2011;35:2684–90.

    Article  PubMed  Google Scholar 

  12. Oyer SL, Smith VA, Lentsch EJ. Reevaluating the prognostic significance of age in differentiated thyroid cancer. Otolaryngol Head Neck Surg. 2012;147:221–6.

    Article  PubMed  Google Scholar 

  13. Bilimoria KY, Bentrem DJ, Linn JG, Freel A, Yeh JJ, Stewart AK, et al. Extent of surgery affects survival for papillary thyroid cancer. Ann Surg. 2007;246:375–81.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Fairhead JF, Rothwell PM. Underinvestigation and undertreatment of carotid disease in elderly patients with transient ischaemic attack and stroke: comparative population based study. BMJ. 2006;333:525–7.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Madan AK, Aliabadi-Wahle S, Beech DJ. Age bias: a cause of underutilization of breast conservation treatment. J Cancer Educ. 2001;16(1):29–32.

    CAS  PubMed  Google Scholar 

  16. Madan AK, Coopeer L, Gratzer A, Beech DJ. Ageism in breast cancer surgical options by medical students. Tenn Med. 2006; 99:37–8, 41.

  17. Beal SH, Chen SL, Schneider PD, Martinez SR. An evaluation of lymph node yield and lymph node ratio in well-differentiated thyroid carcinoma. Am Surg. 2010;76:28–32.

    PubMed  Google Scholar 

  18. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26:1–133.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Abbott AD, Tyni-Lenne R, Hedlund R. The influence of psychological factors on pre-operative levels of pain intensity, disability and health-related quality of life in lumbar spinal fusion surgery patients. Physiotherapy. 2010;96:213–21.

    Article  PubMed  Google Scholar 

  20. Mekel M, Stephen AE, Gaz RD, Perry ZH, Hodin RA, Parangi S. Thyroid surgery in octogenarians is associated with higher complication rates. Surgery. 2009;146:913–21.

    Article  PubMed  Google Scholar 

  21. Goldfarb M, Perry Z, Hodin RA, Parangi S. Medical and surgical risks in thyroid surgery: lessons from the NSQIP. Ann Surg Oncol. 2011;18:3551–8.

    Article  PubMed  Google Scholar 

  22. Wenaas AE, Nagy CZ, Yiu Y, Xu L, Horter K, Zevallos JP. Demographic and socioeconomic factors predictive of compliance with American Thyroid Association guidelines for the treatment for advanced papillary thyroid carcinoma. Head Neck. 2015;37:1776–80.

    Article  PubMed  Google Scholar 

  23. Bilimoria KY, Bentrem DJ, Linn JG, Freel A, Yeh JJ, Stewart AK, et al. Utilization of total thyroidectomy for papillary thyroid cancer in the United States. Surgery. 2007;142:906–13.

    Article  PubMed  Google Scholar 

  24. Jonklaas J, Nogueras-Gonzalez G, Munsell M, Litofsky D, Ain KB, Bigos ST, et al. The impact of age and gender on papillary thyroid cancer survival. J Clin Endocrinol Metab. 2012;97:E878–87.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Lang BH, Lo CY, Wan KY. Long-term outcomes for older patients with papillary thyroid carcinoma: should another age cut-off beyond 45 years be added? Ann Surg Oncol. 2015;22:446–53.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. UC Davis School of Medicine, Sacramento, CA, USA

    I. V. Shevchyk

  2. Department of Surgery, The Everett Clinic, Medical Office Building, 1330 Rockefeller Avenue, Everett, WA, 98201, USA

    B. A. Cobian & S. R. Martinez

Authors
  1. I. V. Shevchyk
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  2. B. A. Cobian
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  3. S. R. Martinez
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Corresponding author

Correspondence to S. R. Martinez.

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Ethical standards

Because SEER data are de-identified, this study was exempt from Institutional Review Board approval. The manuscript does not contain identifiable patient data.

Conflict of interest

The authors declare that they have no conflict of interest.

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Shevchyk, I.V., Cobian, B.A. & Martinez, S.R. Age-based disparities in the use of total thyroidectomy for papillary thyroid carcinoma. Clin Transl Oncol 19, 1253–1259 (2017). https://doi.org/10.1007/s12094-017-1663-9

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  • DOI: https://doi.org/10.1007/s12094-017-1663-9

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