Evaluation of prognosis and risk factors of differentiated thyroid cancer in a geriatric population

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 & GE; 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 & GE; 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 & GE; 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 & GE; 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 & GE; 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.