Clinical features of recently diagnosed papillary thyroid carcinoma in elderly patients aged 65 and older based on 10 years of sonographic experience at a single institution in Korea

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Abstract

Purpose: The aim of this study was to assess the characteristics of papillary thyroid carcinoma (PTC) in patients aged 65 and older in order to predict postoperative recurrence based on the results of ultrasonographic surveillance. Methods: Among 1,494 patients (200 male and 1,294 female; mean age, 46.6±11.3 years) who underwent surgery for thyroid cancer at our institution between 2006 and 2015, we retrospectively enrolled 150 PTC patients (29 male and 121 female; mean age, 69.4±4.2 years) aged 65 years and older. To identify the risk factors for recurrence, we analyzed age, gender, multiplicity, size, number, extrathyroidal extension (ETE) of the tumor, lymph node metastasis (LNM), type of surgery, and the dose of radioactive ablation using a Cox regression model to identify hazard ratios (HRs). Results: Among the 115 asymptomatic patients with PTCs detected by screening ultrasonography (n=86), other cross-sectional imaging modalities (computed tomography or positron emission tomography-computed tomography, n=13), or incidentally through a surgical specimen (n=16), 78 patients were confirmed to have papillary thyroid microcarcinomas (PTMCs). The other 35 patients presented with palpable neck masses (n=25), vocal cord palsy (n=9) or bloodtinged sputum (n=1). During the follow-up period (mean, 43.6 months), 17 patients (12.5%) experienced recurrence in the neck. None of the patients died due to PTC-related recurrence or distant metastasis during the follow-up period. Cox regression analysis demonstrated that tumor size (HR, 2.12; P<0.001) and LNM (central LNM: HR, 9.08; P=0.004; lateral LNM: HR, 14.71; P=0.002; both central and lateral LNM: HR, 58.41; P<0.001) significantly increased the recurrence rate. ETE, LNM, and recurrence were significantly less frequent in PTMCs than in non- PTMC (all P<0.001). Conclusion: PTCs of small size and absent LNM showed significantly better prognoses in patients 65 years and older.

Original languageEnglish
Pages (from-to)355-362
Number of pages8
JournalUltrasonography
Volume36
Issue number4
DOIs
Publication statusPublished - 2017 Oct 1

Fingerprint

Korea
Neoplasm Metastasis
Lymph Nodes
Recurrence
Thyroid Gland
Factor IX
Neck
Papillary Thyroid cancer
Vocal Cord Paralysis
Sputum
Thyroid Neoplasms
Proportional Hazards Models
Ultrasonography
Neoplasms
Tomography
Regression Analysis

Keywords

  • Aged
  • Papillary
  • Papillary thyroid microcarcinoma
  • Surgery
  • Thyroid cancer
  • Treatment outcomes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{049d15e21bd04f21befb41918251d10d,
title = "Clinical features of recently diagnosed papillary thyroid carcinoma in elderly patients aged 65 and older based on 10 years of sonographic experience at a single institution in Korea",
abstract = "Purpose: The aim of this study was to assess the characteristics of papillary thyroid carcinoma (PTC) in patients aged 65 and older in order to predict postoperative recurrence based on the results of ultrasonographic surveillance. Methods: Among 1,494 patients (200 male and 1,294 female; mean age, 46.6±11.3 years) who underwent surgery for thyroid cancer at our institution between 2006 and 2015, we retrospectively enrolled 150 PTC patients (29 male and 121 female; mean age, 69.4±4.2 years) aged 65 years and older. To identify the risk factors for recurrence, we analyzed age, gender, multiplicity, size, number, extrathyroidal extension (ETE) of the tumor, lymph node metastasis (LNM), type of surgery, and the dose of radioactive ablation using a Cox regression model to identify hazard ratios (HRs). Results: Among the 115 asymptomatic patients with PTCs detected by screening ultrasonography (n=86), other cross-sectional imaging modalities (computed tomography or positron emission tomography-computed tomography, n=13), or incidentally through a surgical specimen (n=16), 78 patients were confirmed to have papillary thyroid microcarcinomas (PTMCs). The other 35 patients presented with palpable neck masses (n=25), vocal cord palsy (n=9) or bloodtinged sputum (n=1). During the follow-up period (mean, 43.6 months), 17 patients (12.5{\%}) experienced recurrence in the neck. None of the patients died due to PTC-related recurrence or distant metastasis during the follow-up period. Cox regression analysis demonstrated that tumor size (HR, 2.12; P<0.001) and LNM (central LNM: HR, 9.08; P=0.004; lateral LNM: HR, 14.71; P=0.002; both central and lateral LNM: HR, 58.41; P<0.001) significantly increased the recurrence rate. ETE, LNM, and recurrence were significantly less frequent in PTMCs than in non- PTMC (all P<0.001). Conclusion: PTCs of small size and absent LNM showed significantly better prognoses in patients 65 years and older.",
keywords = "Aged, Papillary, Papillary thyroid microcarcinoma, Surgery, Thyroid cancer, Treatment outcomes",
author = "Kim, {Eun Sil} and Lee, {Young Hen} and Seo, {Hyung Suk} and Son, {Gil Soo} and Kwon, {Soon Young} and Kim, {Young Sik} and Seo, {Ji A} and Kim, {Nan Hee} and Sang-Il Suh and Inseon Ryoo and You, {Sung Hye}",
year = "2017",
month = "10",
day = "1",
doi = "10.14366/usg.17010",
language = "English",
volume = "36",
pages = "355--362",
journal = "Ultrasonography",
issn = "2288-5919",
publisher = "Korean Society of Ultrasound in Medicine",
number = "4",

}

TY - JOUR

T1 - Clinical features of recently diagnosed papillary thyroid carcinoma in elderly patients aged 65 and older based on 10 years of sonographic experience at a single institution in Korea

AU - Kim, Eun Sil

AU - Lee, Young Hen

AU - Seo, Hyung Suk

AU - Son, Gil Soo

AU - Kwon, Soon Young

AU - Kim, Young Sik

AU - Seo, Ji A

AU - Kim, Nan Hee

AU - Suh, Sang-Il

AU - Ryoo, Inseon

AU - You, Sung Hye

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Purpose: The aim of this study was to assess the characteristics of papillary thyroid carcinoma (PTC) in patients aged 65 and older in order to predict postoperative recurrence based on the results of ultrasonographic surveillance. Methods: Among 1,494 patients (200 male and 1,294 female; mean age, 46.6±11.3 years) who underwent surgery for thyroid cancer at our institution between 2006 and 2015, we retrospectively enrolled 150 PTC patients (29 male and 121 female; mean age, 69.4±4.2 years) aged 65 years and older. To identify the risk factors for recurrence, we analyzed age, gender, multiplicity, size, number, extrathyroidal extension (ETE) of the tumor, lymph node metastasis (LNM), type of surgery, and the dose of radioactive ablation using a Cox regression model to identify hazard ratios (HRs). Results: Among the 115 asymptomatic patients with PTCs detected by screening ultrasonography (n=86), other cross-sectional imaging modalities (computed tomography or positron emission tomography-computed tomography, n=13), or incidentally through a surgical specimen (n=16), 78 patients were confirmed to have papillary thyroid microcarcinomas (PTMCs). The other 35 patients presented with palpable neck masses (n=25), vocal cord palsy (n=9) or bloodtinged sputum (n=1). During the follow-up period (mean, 43.6 months), 17 patients (12.5%) experienced recurrence in the neck. None of the patients died due to PTC-related recurrence or distant metastasis during the follow-up period. Cox regression analysis demonstrated that tumor size (HR, 2.12; P<0.001) and LNM (central LNM: HR, 9.08; P=0.004; lateral LNM: HR, 14.71; P=0.002; both central and lateral LNM: HR, 58.41; P<0.001) significantly increased the recurrence rate. ETE, LNM, and recurrence were significantly less frequent in PTMCs than in non- PTMC (all P<0.001). Conclusion: PTCs of small size and absent LNM showed significantly better prognoses in patients 65 years and older.

AB - Purpose: The aim of this study was to assess the characteristics of papillary thyroid carcinoma (PTC) in patients aged 65 and older in order to predict postoperative recurrence based on the results of ultrasonographic surveillance. Methods: Among 1,494 patients (200 male and 1,294 female; mean age, 46.6±11.3 years) who underwent surgery for thyroid cancer at our institution between 2006 and 2015, we retrospectively enrolled 150 PTC patients (29 male and 121 female; mean age, 69.4±4.2 years) aged 65 years and older. To identify the risk factors for recurrence, we analyzed age, gender, multiplicity, size, number, extrathyroidal extension (ETE) of the tumor, lymph node metastasis (LNM), type of surgery, and the dose of radioactive ablation using a Cox regression model to identify hazard ratios (HRs). Results: Among the 115 asymptomatic patients with PTCs detected by screening ultrasonography (n=86), other cross-sectional imaging modalities (computed tomography or positron emission tomography-computed tomography, n=13), or incidentally through a surgical specimen (n=16), 78 patients were confirmed to have papillary thyroid microcarcinomas (PTMCs). The other 35 patients presented with palpable neck masses (n=25), vocal cord palsy (n=9) or bloodtinged sputum (n=1). During the follow-up period (mean, 43.6 months), 17 patients (12.5%) experienced recurrence in the neck. None of the patients died due to PTC-related recurrence or distant metastasis during the follow-up period. Cox regression analysis demonstrated that tumor size (HR, 2.12; P<0.001) and LNM (central LNM: HR, 9.08; P=0.004; lateral LNM: HR, 14.71; P=0.002; both central and lateral LNM: HR, 58.41; P<0.001) significantly increased the recurrence rate. ETE, LNM, and recurrence were significantly less frequent in PTMCs than in non- PTMC (all P<0.001). Conclusion: PTCs of small size and absent LNM showed significantly better prognoses in patients 65 years and older.

KW - Aged

KW - Papillary

KW - Papillary thyroid microcarcinoma

KW - Surgery

KW - Thyroid cancer

KW - Treatment outcomes

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U2 - 10.14366/usg.17010

DO - 10.14366/usg.17010

M3 - Article

AN - SCOPUS:85044372692

VL - 36

SP - 355

EP - 362

JO - Ultrasonography

JF - Ultrasonography

SN - 2288-5919

IS - 4

ER -