Clinical-pathological characteristics and prognostic factors for papillary thyroid microcarcinoma in the elderly

Jing Tang; Hans B. Liu; Lujiao Yu; Xin Meng; Sean X. Leng; Haiyan Zhang

doi:10.7150/jca.22700

Clinical-pathological characteristics and prognostic factors for papillary thyroid microcarcinoma in the elderly

Jing Tang, Hans B. Liu, Lujiao Yu, Xin Meng, Sean X. Leng, Haiyan Zhang

School of Medicine

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Background: The incidence of papillary thyroid microcarcinoma (PTMC) has increased dramatically over the past three decades worldwide. The annual rate of increase in the elderly (=65) PTMC patients is 1.4 times higher than that in the adult ( < 65) PTMC patients. The aim of the present study is to identify the clinical-pathological characteristics and prognostic factors in the elderly PTMC patients. Methods: The source population is PTMC patients whose information is available in the Surveillance, Epidemiology and End Results (SEER) database (2004-2013). We analyzed specific selected clinical-pathological parameters and prognostic factors for the PTMC patients who were aged 65 or above (N=4812). Results: Within the elderly group, the male patients, in comparison to the females, had a higher percentage of lymph-node metastases (5.29% vs. 12.27%, P < 0.001), distant metastasis (0.27% vs. 1.07%, P < 0.001), and stage III-IV tumors (9.19% vs. 15.85%, P < 0.001). Moreover, the elderly patients had a lower median cause-specific survival (CSS) compared with the adult patients (P < 0.001). Stage III-IV disease (hazard ratio (HR): 8.064, P < 0.001) was a strong risk factor for PTMC CSS. Being female (HR: 0.440, P = 0.011), total thyroidectomy (HR: 0.057, P = 0.001), and lobectomy (HR: 0.058, P < 0.001) were all strong protectors of PTMC CSS. Conclusion: Thyroidectomy improved CSS of the elderly PTMC patients. Compared with thyroid lobectomy, total thyroidectomy did not increase CSS for the elderly PTMC patients. The elderly PTMC patients who received radio therapy did not experience an increase in CSS.

Original language	English (US)
Pages (from-to)	256-262
Number of pages	7
Journal	Journal of Cancer
Volume	9
Issue number	2
DOIs	https://doi.org/10.7150/jca.22700
State	Published - 2018

Keywords

Elderly patients
Papillary thyroid microcarcinoma
Prognostic factors
SEER

ASJC Scopus subject areas

Oncology

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10.7150/jca.22700

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@article{92159f1af9f749d4b49a16b33612258a,

title = "Clinical-pathological characteristics and prognostic factors for papillary thyroid microcarcinoma in the elderly",

abstract = "Background: The incidence of papillary thyroid microcarcinoma (PTMC) has increased dramatically over the past three decades worldwide. The annual rate of increase in the elderly (=65) PTMC patients is 1.4 times higher than that in the adult ( < 65) PTMC patients. The aim of the present study is to identify the clinical-pathological characteristics and prognostic factors in the elderly PTMC patients. Methods: The source population is PTMC patients whose information is available in the Surveillance, Epidemiology and End Results (SEER) database (2004-2013). We analyzed specific selected clinical-pathological parameters and prognostic factors for the PTMC patients who were aged 65 or above (N=4812). Results: Within the elderly group, the male patients, in comparison to the females, had a higher percentage of lymph-node metastases (5.29% vs. 12.27%, P < 0.001), distant metastasis (0.27% vs. 1.07%, P < 0.001), and stage III-IV tumors (9.19% vs. 15.85%, P < 0.001). Moreover, the elderly patients had a lower median cause-specific survival (CSS) compared with the adult patients (P < 0.001). Stage III-IV disease (hazard ratio (HR): 8.064, P < 0.001) was a strong risk factor for PTMC CSS. Being female (HR: 0.440, P = 0.011), total thyroidectomy (HR: 0.057, P = 0.001), and lobectomy (HR: 0.058, P < 0.001) were all strong protectors of PTMC CSS. Conclusion: Thyroidectomy improved CSS of the elderly PTMC patients. Compared with thyroid lobectomy, total thyroidectomy did not increase CSS for the elderly PTMC patients. The elderly PTMC patients who received radio therapy did not experience an increase in CSS.",

keywords = "Elderly patients, Papillary thyroid microcarcinoma, Prognostic factors, SEER",

author = "Jing Tang and Liu, {Hans B.} and Lujiao Yu and Xin Meng and Leng, {Sean X.} and Haiyan Zhang",

note = "Funding Information: We would like to thank the staff of the National Cancer Institute and their colleagues across the United States, and the Information Management Services, Inc., all who have been involved with the SEER Program. This work was supported by the National Natural Science Foundation of China (Grant number: 81301838, 81271292, 81572831) and funding from the Irma and Paul Milstein Medical Asian American Partnership (MMAAP) Foundation Program for Senior Health fellows, supported by the MMAAP Foundation (http://www.mmaapf.org), to Dr. Haiyan Zhang. Funding Information: This work was supported by the National Natural Science Foundation of China (Grant number: 81301838, 81271292, 81572831) and funding from the Irma and Paul Milstein Medical Asian American Partnership (MMAAP) Foundation Program for Senior Health fellows, supported by the MMAAP Foundation (http://www.mmaapf.org), to Dr. Haiyan Zhang. Publisher Copyright: {\textcopyright} Ivyspring International Publisher.",

year = "2018",

doi = "10.7150/jca.22700",

language = "English (US)",

volume = "9",

pages = "256--262",

journal = "Journal of Cancer",

issn = "1837-9664",

publisher = "Ivyspring International Publisher",

number = "2",

}

TY - JOUR

T1 - Clinical-pathological characteristics and prognostic factors for papillary thyroid microcarcinoma in the elderly

AU - Tang, Jing

AU - Liu, Hans B.

AU - Yu, Lujiao

AU - Meng, Xin

AU - Leng, Sean X.

AU - Zhang, Haiyan

N1 - Funding Information: We would like to thank the staff of the National Cancer Institute and their colleagues across the United States, and the Information Management Services, Inc., all who have been involved with the SEER Program. This work was supported by the National Natural Science Foundation of China (Grant number: 81301838, 81271292, 81572831) and funding from the Irma and Paul Milstein Medical Asian American Partnership (MMAAP) Foundation Program for Senior Health fellows, supported by the MMAAP Foundation (http://www.mmaapf.org), to Dr. Haiyan Zhang. Funding Information: This work was supported by the National Natural Science Foundation of China (Grant number: 81301838, 81271292, 81572831) and funding from the Irma and Paul Milstein Medical Asian American Partnership (MMAAP) Foundation Program for Senior Health fellows, supported by the MMAAP Foundation (http://www.mmaapf.org), to Dr. Haiyan Zhang. Publisher Copyright: © Ivyspring International Publisher.

PY - 2018

Y1 - 2018

N2 - Background: The incidence of papillary thyroid microcarcinoma (PTMC) has increased dramatically over the past three decades worldwide. The annual rate of increase in the elderly (=65) PTMC patients is 1.4 times higher than that in the adult ( < 65) PTMC patients. The aim of the present study is to identify the clinical-pathological characteristics and prognostic factors in the elderly PTMC patients. Methods: The source population is PTMC patients whose information is available in the Surveillance, Epidemiology and End Results (SEER) database (2004-2013). We analyzed specific selected clinical-pathological parameters and prognostic factors for the PTMC patients who were aged 65 or above (N=4812). Results: Within the elderly group, the male patients, in comparison to the females, had a higher percentage of lymph-node metastases (5.29% vs. 12.27%, P < 0.001), distant metastasis (0.27% vs. 1.07%, P < 0.001), and stage III-IV tumors (9.19% vs. 15.85%, P < 0.001). Moreover, the elderly patients had a lower median cause-specific survival (CSS) compared with the adult patients (P < 0.001). Stage III-IV disease (hazard ratio (HR): 8.064, P < 0.001) was a strong risk factor for PTMC CSS. Being female (HR: 0.440, P = 0.011), total thyroidectomy (HR: 0.057, P = 0.001), and lobectomy (HR: 0.058, P < 0.001) were all strong protectors of PTMC CSS. Conclusion: Thyroidectomy improved CSS of the elderly PTMC patients. Compared with thyroid lobectomy, total thyroidectomy did not increase CSS for the elderly PTMC patients. The elderly PTMC patients who received radio therapy did not experience an increase in CSS.

AB - Background: The incidence of papillary thyroid microcarcinoma (PTMC) has increased dramatically over the past three decades worldwide. The annual rate of increase in the elderly (=65) PTMC patients is 1.4 times higher than that in the adult ( < 65) PTMC patients. The aim of the present study is to identify the clinical-pathological characteristics and prognostic factors in the elderly PTMC patients. Methods: The source population is PTMC patients whose information is available in the Surveillance, Epidemiology and End Results (SEER) database (2004-2013). We analyzed specific selected clinical-pathological parameters and prognostic factors for the PTMC patients who were aged 65 or above (N=4812). Results: Within the elderly group, the male patients, in comparison to the females, had a higher percentage of lymph-node metastases (5.29% vs. 12.27%, P < 0.001), distant metastasis (0.27% vs. 1.07%, P < 0.001), and stage III-IV tumors (9.19% vs. 15.85%, P < 0.001). Moreover, the elderly patients had a lower median cause-specific survival (CSS) compared with the adult patients (P < 0.001). Stage III-IV disease (hazard ratio (HR): 8.064, P < 0.001) was a strong risk factor for PTMC CSS. Being female (HR: 0.440, P = 0.011), total thyroidectomy (HR: 0.057, P = 0.001), and lobectomy (HR: 0.058, P < 0.001) were all strong protectors of PTMC CSS. Conclusion: Thyroidectomy improved CSS of the elderly PTMC patients. Compared with thyroid lobectomy, total thyroidectomy did not increase CSS for the elderly PTMC patients. The elderly PTMC patients who received radio therapy did not experience an increase in CSS.

KW - Elderly patients

KW - Papillary thyroid microcarcinoma

KW - Prognostic factors

KW - SEER

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JO - Journal of Cancer

JF - Journal of Cancer

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Clinical-pathological characteristics and prognostic factors for papillary thyroid microcarcinoma in the elderly

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