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Differentiated thyroid carcinoma in the elderly.

D Casara1, D Rubello, G Saladini

  • 1Department of Radiotherapy, General Hospital, Padova, Italy.

Aging (Milan, Italy)
|December 1, 1992
PubMed
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Elderly patients with differentiated thyroid cancer (DTC) face poorer prognoses due to increased aggressive factors. Early detection and radical treatment, including total thyroidectomy and radioactive iodine (131I) therapy, are crucial for better outcomes.

Area of Science:

  • Endocrinology
  • Oncology
  • Nuclear Medicine

Background:

  • Differentiated thyroid cancer (DTC) affects patients of all ages, but outcomes in elderly individuals require specific investigation.
  • Understanding prognostic factors in older DTC patients is essential for tailoring treatment strategies.

Purpose of the Study:

  • To analyze prognostic factors and therapeutic outcomes in differentiated thyroid cancer (DTC) patients over 60 years old.
  • To compare the characteristics and survival rates of elderly DTC patients with those under 60.

Main Methods:

  • Retrospective analysis of 268 elderly DTC patients (≥60 years) treated between 1967-1987.
  • All patients received total thyroidectomy, radioactive iodine (131I) therapy, and suppressive hormonal therapy.
  • Follow-up included clinical exams, serum thyroglobulin (Tg), 131I total body scans (TBS), and imaging; external radiotherapy and chemotherapy were used selectively.

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Main Results:

  • Elderly DTC patients showed an increased follicular subtype, lower female-to-male ratio, higher rates of extrathyroidal extension, distant metastases (especially bone), and lower 131I uptake in metastases.
  • Ten-year survival was significantly reduced in elderly patients with lymph node and distant metastases compared to younger counterparts.
  • Detectable serum thyroglobulin (Tg) levels strongly correlated with metastatic disease and demonstrated higher sensitivity than TBS for detecting metastatic foci.

Conclusions:

  • Differentiated thyroid cancer (DTC) in the elderly is an aggressive disease, irrespective of histologic type (papillary or follicular).
  • A radical treatment approach involving total thyroidectomy, radioactive iodine (131I) therapy, and suppressive hormonal therapy is recommended for elderly DTC patients.
  • Serum thyroglobulin (Tg) monitoring is a sensitive tool for detecting metastatic disease in this population.