Abstract
Papillary thyroid cancer (PTC) has a good prognosis among patients younger than 45 years old, but the prognosis in elder is worse and treatment strategy is not well established. We retrospectively analyzed the clinical features and outcomes of 433 patients with PTC aged 70 years or older. The patients consisted of three groups: group A (n = 327); patients receiving surgical treatment, group B (n = 51); patients with microcancer (maximal diameter, ≤ 1.0 cm) who did not undergo surgical treatment, group C (n = 55); patients in whom surgery was contraindicated due to age, high surgical risk or complication by other illnesses. In group A, the mean tumor size was 2.6 ± 1.5 cm, and 218 patients (66.7%) had pathologically confirmed lymph node metastasis; 110 patients (33.6%) had extrathyroidal invasion. The 5- and 10-year overall survival rates (OSR) in group A were 97.2% and 85%, respectively, which was significantly higher than the 5-year OSR in group C (62.6%). The 5- and 10-year disease-specific survival rates (DSSR) in group A were 98.5% and 91.3%, respectively, which was also significantly higher than the 5-year DSSR in group C (81.8%). Although the patients in group B did not receive any treatment, none of them demonstrated cause-specific death or progression of disease. Papillary thyroid cancer in elderly patients, except for microcancers, may be biologically aggressive. Thus surgery is recommended for these patients, if their general status is judged able to tolerate the stress of anesthesia and surgery.
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Simpson WJ, McKinney SE, Carruthers JS, et al. Papillary and follicular thyroid cancer. Prognostic factors in 1,578 patients. Am J Med 1987;83:479–488
Harness JK, McLeod MK, Thompson NW, et al. Deaths due to differentiated thyroid cancer: a 46-year perspective. World J Surg 1988;12:623–629
Staunton MD. Thyroid cancer: a multivariate analysis on influence of treatment on long-term survival. Eur J Surg Oncol 1994;20:613–621
Gilliland FD, Hunt WC, Morris DM, et al. Prognostic factors for thyroid carcinoma. A population-based study of 15,698 cases from the Surveillance, Epidemiology and End Results (SEER) program 1973–1991. Cancer 1997;79:564–573
Vini L, Hyer SL, Marshall J, et al. Long-term results in elderly patients with differentiated thyroid carcinoma. Cancer 2003;97:2736–2742
Lin JD, Chao TC, Chen ST, et al. Characteristics of thyroid carcinomas in aging patients. Eur J Clin Invest 2000;30:147–153
Coburn MC, Wanebo HJ. Age correlates with increased frequency of high risk factors in elderly patients with thyroid cancer. Am J Surg 1995;170:471–475
Miccoli P, Iacconi P, Cecchini GM, et al. Thyroid surgery in patients aged over 80 years. Acta Chir Belg 1994;94:222–223
Har-El G, Sidi J, Kahan E, et al. Thyroid cancer in patients 70 years of age or older. Retrospective study of 50 patients. Ann Otol Rhinol Laryngol 1987;96:403–410
Coburn MC, Wanebo HJ. Age correlates with increased frequency of high risk factors in elderly patients with thyroid cancer. Am J Surg 1995;170:471–475
Neuhold N, Kaiser H, Kaserer K. Latent carcinoma of the thyroid in Austria: a systematic autopsy study. Endocrin Pathol 2001;12:23–31
Thorvaldsson SE, Tulinius H, Bjornsson J, et al. Latent thyroid carcinoma in Iceland at autopsy. Pathol Res Pract 1992;188:747–750
Lang W, Borrusch H, Bauer L. Occult carcinomas of the thyroid. Evaluation of 1,020 sequential autopsies. Am J Clin Pathol 1988;90:72–76
Siegal A, Modan M. Latent carcinoma of thyroid in Israel: a study of 260 autopsies. Isr J Med Sci 1981;17:249–253
Sobrinho-Simoes MA, Sambade MC, Goncalves V. Latent thyroid carcinoma at autopsy: a study from Oporto, Portugal. Cancer 1979;43:1702–1706
Yokozawa T, Miyauchi A, Kuma K, et al. Accurate and simple method of diagnosing thyroid nodules the modified technique of ultrasound-guided fine needle aspiration biopsy. Thyroid 1995;5:141–145
Antonelli A, Miccoli P, Ferdeghini M, et al. Role of neck ultrasonography in the follow-up of patients operated on for thyroid cancer. Thyroid 1995;5:25–28
Antonelli A, Miccoli P, Fallahi P, et al. Role of neck ultrasonography in the follow-up of children operated on for thyroid papillary cancer. Thyroid 2003;13:479–484
Japanese Ministry of Health, Labour and Welfare. Abridged Life Table, 2003 (In Japanese)
Ito Y, Uruno T, Nakano K, et al. An observation trial without surgical treatment in patients with papillary microcarcinoma of the thyroid. Thyroid 2003;13:381–387
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Uruno, T., Miyauchi, A., Shimizu, K. et al. Favorable Surgical Results in 433 Elderly Patients with Papillary Thyroid Cancer. World J. Surg. 29, 1497–1501 (2005). https://doi.org/10.1007/s00268-005-7953-3
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DOI: https://doi.org/10.1007/s00268-005-7953-3