Endocrine Abstracts

Introduction: We evaluated the characteristics of differentiated thyroid carcinoma in geriatric patients and factors that influenced long-term survival in this retrospective study design. Among 1188 patients with differentiated thyroid carcinoma who were treated at our institution over the past 7 years, 144 patients were identified who were age 65 years or older(age range:65–88 years) at the time of their initial diagnosis. This study conducted a retrospective analysis of the patients and factors that influenced long-term survival of these 144 patients, who had a median follow-up of 5.5 years (range, 2–7 years).

Results: There were 105 female patients and 39 male patients (female to male ratio, 2.6:1). 86 tumours were papillary, 48 tumours were follicular, and ten tumours were Hurthle cell carcinoma. One hundred 11 (77%) of patients presented with a thyroid mass, and 104 (72.9%) of tumours pathologic stage were T3 or T4. Lymph node disease was evident at presentation in 66 (45.8%) of patients, and distant metastases were documented at diagnosis in 35 (24.3%) of patients. 122 (84.7%) patients underwent total thyroidectomy, and the remaining patients underwent biopsy only. Radioiodine was administered to 108 (75%) patients. The specific survival rates were 93, 90, and 86% at 2, 5, and 7 years follow up respectively. Multivariate analysis showed that the presence of metastases was the most important independent prognostic factor for survival. Survival was greatest in patients with tumours <1 cm in diameter, characterized by the absence of extraglandular spread and lymph node.

Conclusion: Differentiated thyroid carcinoma appears more aggressive in geriatric patients. A large proportion of tumors showed extrathyroid spread and distant metastases. This may justify a more aggressive surgical strategy with possible prophylactic lymphadenectomy, in addition to ablative therapy with iodine and suppressive therapy with levothyroxine.