Clinical Features and Outcome of Thyroid Carcinoma in Patients Aged 75 Years or Older

Nam, Kee Hyun; Yoon, Jong Ho; Chang, Hang Seok; Park, Cheong Soo

Abstract

Purpose
The aim of this study was to investigate the clinical features and outcome of thyroid carcinoma in elderly patients, and to identify factors that influenced survival. METHODS: Among 3, 267 patients with thyroid carcinoma who were treated in the Department of Surgery at Yonsei University College of Medicine from March 1986 to March 2004, 53 patients were identified who were age 75 years or older at the time of diagnosis. The mean age was 78 years (range, 75~90 years) and the mean follow-up was 37.6 months (range, 10~96 months).
RESULTS
There were 41 female and 12 male patients. Forty eight tumors were well-differentiated carcinoma, 5 tumors were undifferentiated or anaplastic carcinoma. Twenty eight patients were in stage T4. Palpable lateral neck node and distant metastases were evident at presentation in 24 and 7 patients, respectively. Forty two patients were completely resected, and 11 patients were unresectable and underwent biopsy only. Of the 42 patients who were completely resected, 30 and 12 patients underwent total and less than total thyroidectomy, repectively. External radiotherapy was administered to 6 patients. The overall survival rate and disease specific survival rate were 49.8% and 51.0% at 5 years, respectively. Multivariate analysis showed that distant metastases and external radiotherapy were independent prognostic factors for survival.
Conclusion
Thyroid carcinoma in patients aged 75 years or older appears to behave more aggressively. Therefore, an optimal therapeutic approach is recommended and should not be withheld on the basis of chronological age. If indicated, aggressive surgery should be necessary to improve survival.