title: Clinicopathologic characteristics and surgical outcomes of elderly patients with thyroid cancer.
abstract: OBJECTIVE
  Age is one of the important prognostic factors in thyroid cancer, and old age is generally related to higher rate of post-operative morbidity and mortality. The study analyzed the characteristics of thyroid cancer in elderly patients compared with those in younger patients.
  
  
  METHODS
  Patients who underwent surgery between 1992 and 2011 were enrolled. The patients were divided into those ≥70 years of age (older group) and <70 years of age (younger group). Data including clinicopathological features and post-operative complications was analyzed. Molecular markers including Galectin-3, Cyclooxygenase-2, bcl-2, Cyclin D1, Epidermal growth factor receptor and BRAF mutation were reviewed. Survival analyses including recurrence-free survival and overall survival were examined.
  
  
  RESULTS
  Of 1867 patients, 98 were age-classified in older group and the remaining 1769 were in younger group. Older group displayed larger tumor size, and increased extrathyroidal extension, vascular invasion and neural invasion than younger group, and all were statistically significant. Molecular marker analyses revealed no significant differences between the groups. Post-operative complication rates were not significantly different between the older and younger groups in both univariate and multivariate analyses. Elderly patients showed poor recurrence-free survival and overall survival than younger patients in univariate analyses. However, age ≥70 years was not associated with poor recurrence-free survival after adjustment of confounding factors.
  
  
  CONCLUSIONS
  Molecular features of elderly patients may be similar with younger patients. Even though aggravated clinicopathological features of thyroid carcinoma are more prevalent in elderly patients, thyroid surgery in elderly patients can be performed with favorable surgical and oncological outcomes.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul.
authors.forename: Hyung Seok
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Chan-Kwon
authors.initials: CK
authors.lastname: Jung
authors.affiliation: Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Sung Hak
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Byung Joo
authors.initials: BJ
authors.lastname: Chae
authors.affiliation: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Lim
authors.affiliation: Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Woo Chan
authors.initials: WC
authors.lastname: Park
authors.affiliation: Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Byung Joo
authors.initials: BJ
authors.lastname: Song
authors.affiliation: Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Jeong Soo
authors.initials: JS
authors.lastname: Kim
authors.affiliation: Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul.
authors.forename: Sang Seol
authors.initials: SS
authors.lastname: Jung
authors.affiliation: Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul drbae@catholic.ac.kr.
authors.forename: Ja Seong
authors.initials: JS
authors.lastname: Bae
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D002851:Chromatography, High Pressure Liquid; D056741:Cyclin D / Q000032:analysis; D051546:Cyclooxygenase 2 / Q000032:analysis; D004252:DNA Mutational Analysis; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000032:analysis; D005260:Female; D037502:Galectin 3 / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D016133:Polymerase Chain Reaction; D048493:Proto-Oncogene Proteins B-raf / Q000235:genetics*; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D013964:Thyroid Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy / Q000009:adverse effects
chemical_list: D014408:Biomarkers, Tumor; D056741:Cyclin D; D037502:Galectin 3; D019253:Proto-Oncogene Proteins c-bcl-2; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D066246:ErbB Receptors; C482119:BRAF protein, human; D048493:Proto-Oncogene Proteins B-raf
keywords: carcinoma; elderly; molecular markers; neoplasms; outcomes; prognosis; surgery; survival; thyroid