Advanced age and differentiated thyroid carcinoma: a retrospective cohort study investigating surgical outcomes and recurrence risk - Summary - MDSpire
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Advanced age and differentiated thyroid carcinoma: a retrospective cohort study investigating surgical outcomes and recurrence risk
To evaluate the clinical characteristics, postoperative complications, and long-term outcomes, including recurrence rates and survival, of differentiated thyroid carcinoma (DTC) in older patients and assess the effect of advanced age on recurrence risk and surgical morbidity.
Key Findings:
Older patients exhibited more aggressive tumor features, including higher rates of extrathyroidal extension (70.6% in Group C vs. 51.6% in Group A, p<0.0001) and distant metastasis (p=0.0006).
Postoperative complications were more common in older patients, with seroma rates at 15.58% in Group C compared to 2.85% in Group A (p<0.0001), and recurrent laryngeal nerve injury at 2.16% vs. 0.45% (p=0.0001), respectively.
Recurrence risk increased with age, with a hazard ratio of 1.894 for patients aged ≥75 years (95% CI: 1.156–3.104, p=0.0113).
Interpretation:
Advanced age correlates with more aggressive DTC and higher recurrence risk, yet thyroidectomy remains an effective treatment option, necessitating close surveillance and tailored monitoring strategies for older patients.
Limitations:
The study is retrospective, which may introduce selection bias affecting the generalizability of the findings.
Exclusion of patients with less than 5 years of follow-up may limit the generalizability of recurrence data.
Conclusion:
Despite the increased risks associated with advanced age, thyroidectomy is a viable treatment for older patients with DTC, highlighting the need for careful monitoring and tailored strategies to optimize outcomes.
by Eun Jin Kim, Seung Jae Lee, Eun Hwa Kim, Ji An Lee, Dong Hyun Seo, Jiahn Park, Sunmi Park, Sungkeun Kang, Sang Wook Kang, Jong Ju Jeong, Kee Hyun Nam, Woong Youn Chung, Young Suk Jo, Jandee Lee
