Defining the role of thyroidectomy in patients with metastatic differentiated thyroid carcinoma by age groups

Metastatic differentiated thyroid cancers (DTCs) may exhibit clinical dormancy before progression, and the impact of early intervention with thyroidectomy by age groups is unknown.

National Cancer Database (NCDB) was queried for patients with metastatic papillary/follicular carcinomas (2010-2021). Multivariable Cox proportional hazard model was used for overall survival (OS) analyses.

There were 5735 patients with metastatic DTCs, with 72.29 ​% diagnosed at age ≥55 years. Thyroidectomy is more often performed for younger age patients (87.54 ​% in age <55 vs. 69.94 ​% in age ≥55). Patients who had thyroidectomy had an improved OS for both age groups (HR 0.25, 95 ​% CI 0.10-0.63 for those <55; HR 0.29, 95 ​% CI 0.22-0.38 for those ≥55). In younger age cohort, those undergoing surgery within 2 weeks were associated with improved OS.

Thyroidectomy is found to improve survival in metastatic DTCs across all age groups. Older individuals may face disparities in surgery utilization.