EVALUATION OF PROGNOSIS AND RISK FACTORS OF DIFFERENTIATED THYROID CANCER IN A GERIATRIC POPULATION

Abstract

Introduction: This retrospective study aimed to investigate the clinical and pathological features of differentiated thyroid cancer and to evaluate treatment outcomes in older adults. Materials and Methods: Data from 1077 patients with differentiated thyroid cancer were noted. These patients were divided into two groups, aged < 65 years and aged ≥ 65 years, and the clinicopathological features of each were compared. Results: Of the 1077 patients, 913 (85%) were under 65 years of age and the remaining 164 (15%) were aged ≥ 65 years. Of those aged < 65 years, 652 (71.4%) had papillary thyroid carcinoma and 261 (28.6%) had follicular thyroid carcinoma. Of the patients aged ≥ 65 years, 116 (70.7%) had papillary thyroid carcinoma and 48 (29.3%) had follicular thyroid carcinoma. The primary tumour size was significantly larger and the incidences of vascular invasion, lymph node metastasis, and distant metastasis were significantly higher in patients aged ≥ 65 years than in the younger patients (p<0.001, p<0.001, p=0.001, and p=0.002, respectively). There was no noteworthy difference between the two groups in terms of the number of tumours, tumour bilaterality, multifocality, and extravascular invasion (p=0.860, p=0.590, p=0.404, and p=0.110, respectively). Conclusion: Primary tumour size was significantly larger and the incidences of vascular invasion, lymph node metastasis, and distant metastasis were significantly higher in patients aged ≥ 65 years. Older patients with differentiated thyroid cancer have worse pathologic features at the time of diagnosis therefore need more aggressive treatment such as more frequent and higher doses of radioiodine treatment. Keywords: Thyroid Neoplasms; Thyroid Cancer, Papillary; Adenocarcinoma, Follicular; Neoplasm Metastasis; Geriatrics..