title: Cancer of the thyroid gland in geriatric age: a single center retrospective study with a 10-year post-operative follow-up.
abstract: BACKGROUND
  We evaluated the characteristics of thyroid carcinoma in geriatric patients and outcomes after a 10-years follow-up.
  
  
  METHODS
  Comparative retrospective study on a group of 31 geriatric patients and one of 224 non-geriatric, who underwent surgery for thyroid carcinoma in the period 1998-2003. We compared with Fisher's exact test: histology, multifocality, tumor size, lymph-node metastasis, distant metastasis, persistence/recurrence and mortality, including and excluding anaplastic carcinomas, in a subgroup of 26 geriatric patients and another of 223 non-geriatric patients.
  
  
  RESULTS
  RESULTS for the geriatric and non-geriatric groups and in the geriatric and non-geriatric subgroups respectively were as follows: multifocality 9/31 vs. 74/224 (p-value 0.8382) and 9/26 vs. 74/223 (p-value 1); tumor size: 16/31 vs. 28/224 T3-T4 (p-value < 0.0001) and 11/26 vs. 27/223 T3-T4 (p-value 0.0004); lymph-node metastases: 17/31 vs. 34/224 (p-value < 0.0001) and 12/26 vs. 33/223 (p-value 0.0004); distant metastases: 8/31 vs. 3/224 (p-value < 0.0001) and 3/26 vs. 2/223 (p-value 0.0088); disease recurrence/persistence: 11/31 vs. 3/224 (p-value < 0.0001) and 6/26 vs. 2/223 (p-value > 0.0001); mortality: 7/31 vs. 2/224 (p-value < 0.0001) and 2/26 vs. 1/223 (p-value 0.0295). Anaplastic carcinomas were predominantly in the geriatric group: 5 vs. 1 (p-value < 0.0001). No statistical differences for other histotypes.
  
  
  CONCLUSIONS
  Thyroid carcinoma is more aggressive in geriatric patients. This may justify a more aggressive surgical strategy with possible prophylactic lymphadenectomy, in addition to ablative therapy with (131)I and suppressive therapy with levothyroxine.
  
  
  CONCLUSIONS
  It would be useful to undertake randomized prospective studies on a large cohort of patients to determine the most effective therapy for geriatric patients suffering from thyroid carcinoma.
authors.affiliation: Fifth Division of General Surgery and Special Surgical Techniques, Department of General and Specialist Surgery, Second University of Naples, Piazza L. Miraglia, 2, 80134 Napoli, Italy. Electronic address: giuseppesantangelo@email.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Santangelo
authors.affiliation: Fifth Division of General Surgery and Special Surgical Techniques, Department of General and Specialist Surgery, Second University of Naples, Piazza L. Miraglia, 2, 80134 Napoli, Italy. Electronic address: santolo.delgiudice@libero.it.
authors.forename: Santolo
authors.initials: S
authors.lastname: Del Giudice
authors.affiliation: Fifth Division of General Surgery and Special Surgical Techniques, Department of General and Specialist Surgery, Second University of Naples, Piazza L. Miraglia, 2, 80134 Napoli, Italy. Electronic address: federicagallucci@hotmail.it.
authors.forename: Federica
authors.initials: F
authors.lastname: Gallucci
authors.affiliation: Fifth Division of General Surgery and Special Surgical Techniques, Department of General and Specialist Surgery, Second University of Naples, Piazza L. Miraglia, 2, 80134 Napoli, Italy. Electronic address: umberto.parmeggiani@unina2.it.
authors.forename: Umberto
authors.initials: U
authors.lastname: Parmeggiani
authors.affiliation: Fifth Division of General Surgery and Special Surgical Techniques, Department of General and Specialist Surgery, Second University of Naples, Piazza L. Miraglia, 2, 80134 Napoli, Italy. Electronic address: massimo.defalco@unina2.it.
authors.forename: Massimo
authors.initials: M
authors.lastname: De Falco
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery; D018278:Carcinoma, Neuroendocrine; D002291:Carcinoma, Papillary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009378:Neoplasms, Multiple Primary / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D013965:Thyroidectomy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Endocrine surgical procedure; Geriatric health; Thyroid carcinoma