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Should patient age be incorporated into Oncocytic thyroid carcinoma staging? Evidence from SEER and NCDB
Milanie Milan1, Samantha M Thomas2, Joyanne Terry3
1Department of Surgery, Duke University Medical Center, Durham, NC, USA.
Introduction:
Age is central to differentiated thyroid cancer staging, however its relevance in oncocytic thyroid carcinoma (OTC) remains unclear. We sought to identify a prognostically meaningful age threshold for OTC.
Methods:
Using SEER (2004-2022) and NCDB (2004-2020), restricted cubic splines (RCS) evaluated potential age prognostic thresholds for OTC; Cox models assessed age in relation to overall survival (OS) in both databases and disease-specific survival (DSS) in SEER.
Results:
Among 14,624 patients (4114 SEER; 10,510 NCDB), median age was 59 years. RCS demonstrated a linear association between age and survival, indicating that there is no prognostic age threshold. Modeled continuously, age was associated with worse adjusted OS in SEER and NCDB (HR 1.08; 95% CI 1.08-1.09; p < 0.001 for both) and worse adjusted DSS in SEER (HR 1.06; 95% CI 1.04-1.07; p < 0.001).
Conclusion:
No discrete age threshold for survival was identified, cautioning against the use of age-based cutoffs in staging for OTC.
