title: Differentiated thyroid cancer in the elderly: our experience.
abstract: BACKGROUND
  The objective of this retrospective study was to investigate clinical and pathologic characteristics of differentiated thyroid cancer in elderly patients and to evaluate the results of surgical treatment in this age group.
  
  
  METHODS
  The clinical records of patients who underwent total thyroidectomy between 2002 and 2012 with histopathological diagnosis of differentiated thyroid cancer were analyzed. Patients were divided into two groups: those 65 years old or older were included in group A (101), those younger in group B (354).
  
  
  RESULTS
  The mean surgical time was 100.9 ± 30.5 min in group A and 100.7 ± 27.6 in B. Postoperative stay was significantly longer in group A (2.8 ± 1.5 days vs 2.4 ± 0.7; p < 0.01). Classic papillary carcinoma was more frequent in group B, whereas follicular variant of papillary carcinoma and tall cell carcinoma in A. In group B node metastases were nearly twice. In Group A transient hypoparathyroidism occurred in 25 patients (24.8%), permanent hypoparathyroidism in 4 (4%), hematoma in 6 (5.9%), recurrent nerve palsy in 2 (2%), and wound infection in 2 (2%). In group B transient and permanent hypoparathyroidism occurred in 48 and 7 patients respectively (13.6% and 2%), hematoma in 4 (1.1%), recurrent nerve palsy in 5 (1.4%), and wound infection in 1 (0.3%).
  
  
  CONCLUSIONS
  Differentiated thyroid carcinoma is more aggressive in elderly patients for biological causes connected to age and to histotype but also for the diagnostic delay. Thyroid surgery in elderly patients is safe when the procedure is carried out by experienced staff. Total thyroidectomy is the surgical operation of choice.
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. Electronic address: pgcalo@unica.it.
authors.forename: Pietro Giorgio
authors.initials: PG
authors.lastname: Calò
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. Electronic address: fabiomedas@gmail.com.
authors.forename: Fabio
authors.initials: F
authors.lastname: Medas
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. Electronic address: giulialoi@hotmail.it.
authors.forename: Giulia
authors.initials: G
authors.lastname: Loi
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. Electronic address: enricoerdas@medicina.unica.it.
authors.forename: Enrico
authors.initials: E
authors.lastname: Erdas
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. Electronic address: gpisano@unica.it.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pisano
authors.affiliation: Department of Surgical Sciences, University of Cagliari, Cagliari, Italy. Electronic address: nicolosi@unica.it.
authors.forename: Angelo
authors.initials: A
authors.lastname: Nicolosi
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology / Q000601:surgery*; D018249:Adenoma, Oxyphilic; D000328:Adult; D000367:Age Factors; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D002291:Carcinoma, Papillary; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D007011:Hypoparathyroidism / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000473:pathology / Q000601:surgery*; D013965:Thyroidectomy; D014826:Vocal Cord Paralysis / Q000453:epidemiology
keywords: Elderly; Thyroid cancer; Thyroidectomy