Indications for thyroid cancer surgery in elderly patients.
OBJECTIVE
To define the indications for thyroid cancer surgery in elderly patients.


METHODS
We compared the clinical characteristics of thyroid cancers in 85 elderly patients, defined as those aged > or =75 years, with those of 37 young patients, defined as those aged <30 years. The elderly group included patients who underwent surgery and/or reoperation and those managed nonoperatively. All patients were treated during an 11-year period from 1994 to 2004 at the Cancer Institute Hospital.


RESULTS
The elderly patients with papillary thyroid carcinoma had a significantly worse cumulative 5-year survival rate than the young patients with papillary thyroid carcinoma (92% vs 100%: P = 0.03). However, there was no significant difference in the survival of patients with low-risk tumors between the two age groups. The cumulative 2-year survival rate of elderly patients with a high-risk tumor was significantly lower in patients not treated with surgery than in those treated surgically (80% vs 100%: P = 0.02). Quality of life (QOL) was severely impaired in 67% and 6% of the nonoperated and operated patients, respectively.


CONCLUSIONS
These results suggest that surgery for thyroid cancer increases the survival rate and promotes the QOL of elderly patients if they are well enough to tolerate the procedure.
Matsuyama
Hiroshi
H
Department of Otolaryngology, Niigata University Faculty of Medicine, Chuo-ku, Niigata, Japan.
Sugitani
Iwao
I
Fujimoto
Yoshihide
Y
Kawabata
Kazuyoshi
K
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D018709:Statistics, Nonparametric; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult