Skip to main content

Advertisement

SpringerLink
Log in

Differentiated thyroid carcinoma in the elderly: influence of age on disease-free and overall survival

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Purpose

We investigated whether age at diagnosis of differentiated thyroid carcinoma (DTC) may be a risk factor for structural disease and mortality after primary treatment in aging patients.

Methods

A multicenter, retrospective analysis including patients older than 60 years at DCT diagnosis was designed. All subjects were treated by surgery with or without radioiodine adjuvant therapy and had a minimum follow-up of one year. We compared elderly patients (group 1, 60–74 years) with very old patients (group 2, ≥75 years).

Results

The study involved 1668 patients (74.3% women, median age 67 years, 87.6% papillary thyroid cancer, 73.3% treated with radioiodine), including 1397 in group 1 and 271 in group 2. Patients in group 2 had larger tumor size (1.8 [0.8–3.0] vs 1.5 [0.7–2.8] cm; P = 0.005), higher proportions of tumors with vascular invasion (23.8 vs 16.4%; P = 0.006), and lower proportion of lymphocytic thyroiditis (18.6 vs 24.9%; P = 0.013) than subjects in group 1. Kaplan–Meier survival analysis showed that patients in group 2 had significantly lower structural disease-free survival (DFS) and overall survival (OS) than patients in group 1 (P = 0.035 and <0.001, respectively). In multivariate Cox regression analysis, age was a risk factor significantly associated with OS. However, age was significantly associated with DFS in unadjusted analysis and in analysis adjusted by gender and risk classification variables, but not when pathological and therapy-related variables were introduced in the model. On the other hand, patients who received radioiodine had worse DFS (P < 0.001) compared to those who did not.

Conclusion

Although age is a conditioning factor for OS, very old patients do not have a greater risk of developing structural disease throughout the follow-up than elderly patients with DTC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

Data are available through a reasonable request to the corresponding author.

References

  1. F.A. Verburg, U. Mäder, K. Tanase, E.D. Thies, S. Diessl, A.K. Buck, M. Luster, C. Reiners, Life expectancy is reduced in differentiated thyroid cancer patients ≥ 45 years old with extensive local tumor invasion, lateral lymph node, or distant metastases at diagnosis and normal in all other DTC patients. J. Clin. Endocrinol. Metab. 98(1), 172–180 (2013). https://doi.org/10.1210/jc.2012-2458.

    Article  CAS  PubMed  Google Scholar 

  2. E.L. Mazzaferri, Long-term outcome of patients with differentiated thyroid carcinoma: effect of therapy. Endocr. Pract. 6(6), 469–476 (2000). https://doi.org/10.4158/EP.6.6.469.

    Article  CAS  PubMed  Google Scholar 

  3. R.H. Grogan, S.P. Kaplan, H. Cao, R.E. Weiss, L.J. Degroot, C.A. Simon, O.M. Embia, P. Angelos, E.L. Kaplan, R.B. Schechter, A study of recurrence and death from papillary thyroid cancer with 27 years of median follow-up. Surgery. 154((6):1436-46), discussion 1446–discussion 1447 (2013). https://doi.org/10.1016/j.surg.2013.07.008.

    Article  Google Scholar 

  4. K.M. van Tol, E.G. de Vries, R.P. Dullaart, T.P. Links, Differentiated thyroid carcinoma in the elderly. Crit. Rev. Oncol. Hematol. 38(1), 79–91 (2001). https://doi.org/10.1016/s1040-8428(00)00127-x. AprPMID: 11255083.

    Article  PubMed  Google Scholar 

  5. L. Vini, S.L. Hyer, J. Marshall, R. A’Hern, C. Harmer, Long-term results in elderly patients with differentiated thyroid carcinoma. Cancer 97(11), 2736–2742 (2003). https://doi.org/10.1002/cncr.11410.

    Article  PubMed  Google Scholar 

  6. J. Jonklaas, G. Nogueras-Gonzalez, M. Munsell, D. Litofsky, K.B. Ain, S.T. Bigos, J.D. Brierley, D.S. Cooper, B.R. Haugen, P.W. Ladenson, J. Magner, J. Robbins, D.S. Ross, M.C. Skarulis, D.L. Steward, H.R. Maxon, S.I. Sherman, National Thyroid Cancer Treatment Cooperative Study Group. The impact of age and gender on papillary thyroid cancer survival. J. Clin. Endocrinol. Metab. 97(6), E878–E887 (2012). https://doi.org/10.1210/jc.2011-2864.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. J.M. Wiener, J. Tilly, Population ageing in the United States of America: implications for public programmes. Int. J. Epidemiol. 31(4), 776–781 (2002). https://doi.org/10.1093/ije/31.4.776. Aug

    Article  PubMed  Google Scholar 

  8. J.D. Lin, T.C. Chao, S.T. Chen, H.F. Weng, K.D. Lin, Characteristics of thyroid carcinomas in aging patients. Eur. J. Clin. Invest. 30(2), 147–153 (2000). https://doi.org/10.1046/j.1365-2362.2000.00598.x.

    Article  CAS  PubMed  Google Scholar 

  9. A. Longheu, F. Medas, G. Pisano, L. Gordini, A. Nicolosi, S. Sorrenti, E. Erdas, P.G. Calò, Differentiated thyroid cancer in patients ≥75 years: Histopathological features and results of surgical treatment. Int. J. Surg. 33(Suppl 1), S159–S163 (2016). https://doi.org/10.1016/j.ijsu.2016.07.001.

    Article  PubMed  Google Scholar 

  10. L.G. Morris, A.G. Sikora, T.D. Tosteson, L. Davies, The increasing incidence of thyroid cancer: the influence of access to care. Thyroid 23(7), 885–891 (2013). https://doi.org/10.1089/thy.2013.0045.

    Article  PubMed  PubMed Central  Google Scholar 

  11. H.S. Park, S.A. Roman, J.A. Sosa, Treatment patterns of aging Americans with differentiated thyroid cancer. Cancer 116(1), 20–30 (2010). https://doi.org/10.1002/cncr.24717.

    Article  PubMed  Google Scholar 

  12. P.G. Calò, F. Medas, G. Loi, E. Erdas, G. Pisano, A. Nicolosi, Differentiated thyroid cancer in the elderly: our experience. Int. J. Surg. 12(Suppl 2), S140–S143 (2014). https://doi.org/10.1016/j.ijsu.2014.08.362.

    Article  PubMed  Google Scholar 

  13. F.D. Dellal, D. Özdemir, A.A. Tam, H. Baser, H. Tatli Dogan, O. Parlak, R. Ersoy, B. Cakir, Clinicopathological features of thyroid cancer in the elderly compared to younger counterparts: single-center experience. J. Endocrinol. Invest. 40(5), 471–479 (2017). https://doi.org/10.1007/s40618-016-0577-7.

    Article  CAS  PubMed  Google Scholar 

  14. L. Falvo, A. Catania, S. Sorrenti, V. D’Andrea, A. Berni, M. De Stefano, E. De Antoni, Prognostic significance of the age factor in the thyroid cancer: statistical analysis. J. Surg. Oncol. 88(4), 217–222 (2004). https://doi.org/10.1002/jso.20140.

    Article  PubMed  Google Scholar 

  15. C.S. Hollenbeak, M.M. Boltz, E.W. Schaefer, B.D. Saunders, D. Goldenberg, Recurrence of differentiated thyroid cancer in the elderly. Eur. J. Endocrinol. 168(4), 549–556 (2013). https://doi.org/10.1530/EJE-12-0848.

    Article  CAS  PubMed  Google Scholar 

  16. A. Toniato, C. Bernardi, A. Piotto, D. Rubello, M.R. Pelizzo, Features of papillary thyroid carcinoma in patients older than 75 years. Updates Surg. 63(2), 115–118 (2011). https://doi.org/10.1007/s13304-011-0060-0. JunEpub 2011 Mar 17.

    Article  PubMed  Google Scholar 

  17. M. Papaleontiou, M.R. Haymart, Approach to and treatment of thyroid disorders in the elderly. Med. Clin. North Am. 96(2), 297–310 (2012). https://doi.org/10.1016/j.mcna.2012.01.013.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. P. Trimboli, A. Piccardo, A. Signore, S. Valabrega, A. Barnabei, G. Santolamazza, A. Di Paolo, V. Stati, A. Chiefari, S. Vottari, M. Simmaco, G. Ferrarazzo, L. Ceriani, M. Appetecchia, L. Giovanella, Patient Age Is an Independent Risk Factor of Relapse of Differentiated Thyroid Carcinoma and Improves the Performance of the American Thyroid Association Stratification System. Thyroid 30(5), 713–719 (2020). https://doi.org/10.1089/thy.2019.0688.

    Article  CAS  PubMed  Google Scholar 

  19. N. Chereau, C. Trésallet, S. Noullet, G. Godiris-Petit, F. Tissier, L. Leenhardt, F. Menegaux, Prognosis of papillary thyroid carcinoma in elderly patients after thyroid resection: a retrospective cohort analysis. Medicine (Baltimore) 95(47), e5450 (2016). https://doi.org/10.1097/MD.0000000000005450.

    Article  Google Scholar 

  20. M.R. Haymart, Understanding the relationship between age and thyroid cancer. Oncologist. 14(3), 216–221 (2009). https://doi.org/10.1634/theoncologist.2008-0194.

    Article  PubMed  Google Scholar 

  21. M. Raffaelli, R. Bellantone, P. Princi, C. De Crea, E.D. Rossi, G. Fadda, C.P. Lombardi, Surgical treatment of thyroid diseases in elderly patients. Am. J. Surg. 200(4), 467–472 (2010). https://doi.org/10.1016/j.amjsurg.2009.12.020.

    Article  PubMed  Google Scholar 

  22. Tuttle M.M., Haugen B., Shah J., Sosa J.A., Rohren E., Subramaniam R.M., Hunt J.L.P.N. Thyroid differentiated and anaplastic carcinoma. In: AminMB Edge S.,Greene F., ByrdDR, Brookland R.K., Washington M.K., Gershenwald J.E. Compton C.C., Hess K.R., Sullivan D.C., Jessup J.M., Brierley J.D., Gaspar L.E., Schilsky R.L. Balch C.M., Winchester D.P., Asare E.A., Madera M., Gress D.M.,Meyer L.R., eds. AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer International; 2017.

  23. K.R. Joseph, S. Edirimanne, G.D. Eslick, Thyroidectomy for thyroid cancer in the elderly: A meta-analysis. Eur. J. Surg. Oncol. 45(3), 310–317 (2019). https://doi.org/10.1016/j.ejso.2018.07.055.

    Article  PubMed  Google Scholar 

  24. B.R. Haugen, E.K. Alexander, K.C. Bible, G.M. Doherty, S.J. Mandel, Y.E. Nikiforov, F. Pacini, G.W. Randolph, A.M. Sawka, M. Schlumberger, K.G. Schuff, S.I. Sherman, J.A. Sosa, D.L. Steward, R.M. Tuttle, L. Wartofsky, 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 26(1), 1–133 (2016). https://doi.org/10.1089/thy.2015.0020.

    Article  PubMed  PubMed Central  Google Scholar 

  25. R.M. Tuttle, H. Tala, J. Shah, R. Leboeuf, R. Ghossein, M. Gonen, M. Brokhin, G. Omry, J.A. Fagin, A. Shaha, Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system. Thyroid 20(12), 1341–1349 (2010). https://doi.org/10.1089/thy.2010.0178.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. D.P. Momesso, F. Vaisman, S.P. Yang, D.A. Bulzico, R. Corbo, M. Vaisman, R.M. Tuttle, Dynamic Risk Stratification in Patients with Differentiated Thyroid Cancer Treated Without Radioactive Iodine. J. Clin. Endocrinol. Metab. 101(7), 2692–2700 (2016). https://doi.org/10.1210/jc.2015-4290.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. X. Wang, J. Lei, T. Wei, J. Zhu, Z. Li, Clinicopathological characteristics and recurrence risk of papillary thyroid microcarcinoma in the elderly. Cancer Manag. Res. 11, 2371–2377 (2019). https://doi.org/10.2147/CMAR.S198451.

    Article  PubMed  PubMed Central  Google Scholar 

  28. I.J. Nixon, L.Y. Wang, J.C. Migliacci, A. Eskander, M.J. Campbell, A. Aniss, L. Morris, F. Vaisman, R. Corbo, D. Momesso, M. Vaisman, A. Carvalho, D. Learoyd, W.D. Leslie, R.W. Nason, D. Kuk, V. Wreesmann, L. Morris, F.L. Palmer, I. Ganly, S.G. Patel, B. Singh, R.M. Tuttle, A.R. Shaha, M. Gönen, K.A. Pathak, W.T. Shen, M. Sywak, L. Kowalski, J. Freeman, N. Perrier, J.P. Shah, An International Multi-Institutional Validation of Age 55 Years as a Cutoff for Risk Stratification in the AJCC/UICC Staging System for Well-Differentiated Thyroid Cancer. Thyroid 26(3), 373–380 (2016). https://doi.org/10.1089/thy.2015.0315.

    Article  PubMed  PubMed Central  Google Scholar 

  29. S. Shah, L. Boucai, Effect of age on response to therapy and mortality in patients with thyroid cancer at high risk of recurrence. J. Clin. Endocrinol. Metab. 103(2), 689–697 (2018). https://doi.org/10.1210/jc.2017-02255.

    Article  PubMed  Google Scholar 

  30. Y. Kim, J.L. Roh, D. Song, K.J. Cho, S.H. Choi, S.Y. Nam, S.Y. Kim, Predictors of recurrence after total thyroidectomy plus neck dissection and radioactive iodine ablation for high-risk papillary thyroid carcinoma. J. Surg. Oncol. 122(5), 906–913 (2020). https://doi.org/10.1002/jso.26090.

    Article  PubMed  Google Scholar 

  31. M. Kim, Y.N. Kim, W.G. Kim, S. Park, H. Kwon, M.J. Jeon, H.S. Ahn, S.H. Jung, S.W. Kim, W.B. Kim, J.H. Chung, Y.K. Shong, T.H. Kim, T.Y. Kim, Optimal cut-off age in the TNM Staging system of differentiated thyroid cancer: is 55 years better than 45 years? Clin Endocrinol (Oxf) 86(3), 438–443 (2017). https://doi.org/10.1111/cen.13254.

    Article  Google Scholar 

  32. L. Lamartina, G. Grani, E. Arvat, A. Nervo, M.C. Zatelli, R. Rossi, E. Puxeddu, S. Morelli, M. Torlontano, M. Massa, R. Bellantone, A. Pontecorvi, T. Montesano, L. Pagano, L. Daniele, L. Fugazzola, G. Ceresini, R. Bruno, R. Rossetto, S. Tumino, M. Centanni, D. Meringolo, M.G. Castagna, D. Salvatore, A. Nicolucci, G. Lucisano, S. Filetti, C. Durante, 8th edition of the AJCC/TNM staging system of thyroid cancer: what to expect (ITCO#2). Endocr Relat Cancer 25(3), L7–L11 (2018). https://doi.org/10.1530/ERC-17-0453.

    Article  PubMed  Google Scholar 

  33. L. Yang, W. Shen, N. Sakamoto, Population-based study evaluating and predicting the probability of death resulting from thyroid cancer and other causes among patients with thyroid cancer. J. Clin. Oncol. 31(4), 468–474 (2013). https://doi.org/10.1200/JCO.2012.42.4457.

    Article  PubMed  Google Scholar 

  34. B.H. Lang, C.Y. Lo, K.P. Wong, K.Y. Wan, Long-term outcomes for older patients with papillary thyroid carcinoma: should another age cutoff beyond 45 years be added? Ann. Surg. Oncol. 22(2), 446–453 (2015). https://doi.org/10.1245/s10434-014-4055-1.

    Article  PubMed  Google Scholar 

  35. E.F.S. van Velsen, M.T. Stegenga, F.J. van Kemenade, B.L.R. Kam, T.M. van Ginhoven, W.E. Visser, R.P. Peeters, Evaluating the 2015 American Thyroid Association Risk Stratification System in High-Risk Papillary and Follicular Thyroid Cancer Patients. Thyroid 29(8), 1073–1079 (2019). https://doi.org/10.1089/thy.2019.0053.

    Article  CAS  PubMed  Google Scholar 

  36. E.F.S. van Velsen, R.P. Peeters, M.T. Stegenga, F.J. van Kemenade, T.M. van Ginhoven, F.A. Verburg, W.E. Visser, The influence of age on disease outcome in 2015 ATA high-risk differentiated thyroid cancer patients. Eur. J. Endocrinol. 185(3), 421–429 (2021). https://doi.org/10.1530/EJE-21-0365.

    Article  PubMed  Google Scholar 

  37. Q. Xia, S. Dong, P.D. Bian, J. Wang, C.J. Li, Effects of endocrine therapy on the prognosis of elderly patients after surgery for papillary thyroid carcinoma. Eur. Arch. Otorhinolaryngol 273(4), 1037–1043 (2016). https://doi.org/10.1007/s00405-015-3564-2.

    Article  PubMed  Google Scholar 

  38. G. Hu, W. Zhu, W. Yang, H. Wang, L. Shen, H. Zhang, The effectiveness of radioactive iodine remnant ablation for papillary thyroid microcarcinoma: a systematic review and meta-analysis. World J. Surg. 40(1), 100–109 (2016). https://doi.org/10.1007/s00268-015-3346-4.

    Article  CAS  PubMed  Google Scholar 

  39. H. Kwon, M.J. Jeon, W.G. Kim, S. Park, M. Kim, T.Y. Kim, M. Han, D.E. Song, T.Y. Sung, J.H. Yoon, S.J. Hong, J.S. Ryu, Y.K. Shong, W.B. Kim, Lack of efficacy of radioiodine remnant ablation for papillary thyroid microcarcinoma: verification using inverse probability of treatment weighting. Ann Surg Oncol 24(9), 2596–2602 (2017). https://doi.org/10.1245/s10434-017-5910-7.

    Article  PubMed  Google Scholar 

  40. K. Marvin, K. Parham, Differentiated thyroid cancer in people aged 85 and older. J. Am. Geriatr. Soc. 63(5), 932–937 (2015). https://doi.org/10.1111/jgs.13397.

    Article  PubMed  Google Scholar 

  41. M. Schlumberger, C. Challeton, F. De Vathaire, J.P. Travagli, P. Gardet, J.D. Lumbroso, C. Francese, F. Fontaine, M. Ricard, C. Parmentier, Radioactive iodine treatment and external radiotherapy for lung and bone metastases from thyroid carcinoma. J. Nucl. Med. 37(4), 598–605 (1996).

    CAS  PubMed  Google Scholar 

  42. G.C. Biliotti, F. Martini, V. Vezzosi, P. Seghi, F. Tozzi, A. Castagnoli, G. Basili, A. Peri, Specific features of differentiated thyroid carcinoma in patients over 70 years of age. J. Surg. Oncol. 93(3), 194–198 (2006). https://doi.org/10.1002/jso.20512.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Endocrinology, Hospital Universitario Puerta de Hierro Majadahonda, Instituto de Investigación Sanitaria Puerta de Hierro Segovia de Arana, Majadahonda, Spain

    Juan J. Díez & Pedro Iglesias

  2. Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain

    Juan J. Díez & Pedro Iglesias

  3. Department of Endocrinology, Hospital Universitario de Navarra, Pamplona, Spain

    Emma Anda

  4. Department of Endocrinology, Hospital Severo Ochoa, Leganés, Spain

    Victoria Alcazar

  5. Department of Endocrinology, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain

    María L. Isidro

  6. Department of Endocrinology, Hospital Clínico San Carlos, Madrid, Spain

    Cristina Familiar

  7. Department of Endocrinology, Hospital Universitario de Basurto, Bilbao, Spain

    Miguel Paja & Amelia Oleaga

  8. Department of Medicine, Universidad del País Vasco, Leioa, Spain

    Miguel Paja & Amelia Oleaga

  9. Department of Endocrinology, Hospital Universitario La Paz, Madrid, Spain

    Patricia Rojas Marcos

  10. Department of Endocrinology, Complejo Asistencial Universitario de León, León, Spain

    Begoña Pérez-Corral

  11. Department of Endocrinology, Hospital Universitario Virgen del Rocío, Sevilla, Spain

    Elena Navarro & Ana R. Romero-Lluch

  12. Department of Endocrinology, Hospital Royo Villanova, Zaragoza, Spain

    María J. Pamplona

  13. Department of Endocrinology, Hospital Regional Universitario de Málaga (IBIMA), Universidad de Málaga, Málaga, Spain

    José C. Fernández-García

  14. Department of Endocrinology, Hospital Universitario de Tarragona Joan XXIII, IISPV, Universitat Rovira i Virgili, Ciberdem, Tarragona, Spain

    Ana Megía

  15. Department of Endocrinology, Hospital Universitario Central de Asturias & Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain

    Laura Manjón & Cecilia Sánchez-Ragnarsson

  16. Department of Endocrinology, Complejo Hospitalario de Toledo, Toledo, Spain

    Julia Sastre

Authors
  1. Juan J. Díez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emma Anda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Victoria Alcazar
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. María L. Isidro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Cristina Familiar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Miguel Paja
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Patricia Rojas Marcos
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Begoña Pérez-Corral
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Elena Navarro
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Ana R. Romero-Lluch
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Amelia Oleaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. María J. Pamplona
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. José C. Fernández-García
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Ana Megía
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Laura Manjón
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Cecilia Sánchez-Ragnarsson
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Pedro Iglesias
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Julia Sastre
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and design: JJD. Administrative support: all authors. Provision of study materials or patients: all authors. Collection and assembly of data: all authors. Data analysis and interpretation: all authors. Manuscript writing: all authors. Final approval of manuscript: all authors.

Corresponding author

Correspondence to Juan J. Díez.

Ethics declarations

Conflict of interest

The authors declare no competing interests.

Ethical approval

This study received the approval by the ethics committee of the Hospital Universitario Puerta de Hierro Majadahonda (PI 235-20).

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Díez, J.J., Anda, E., Alcazar, V. et al. Differentiated thyroid carcinoma in the elderly: influence of age on disease-free and overall survival. Endocrine 77, 121–133 (2022). https://doi.org/10.1007/s12020-022-03059-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-022-03059-y

Keywords

Search

Navigation