title: Impact of neck failure on survival in older patients with differentiated thyroid cancer.
abstract: Regional recurrence of differentiated thyroid cancer (DTC) is often salvaged with neck dissection without survival penalty. It is unknown whether recurrence may be associated with inferior survival in older patients.
  
  
  
  Surveillance, Epidemiology, and End Results (SEER) and Medicare data were linked to identify patients age ≥65 with nonmetastatic DTC. Patients undergoing neck dissection >6 months after their initial diagnosis were considered to have regional recurrent disease. We compared overall survival (OS) and cause-specific survival (CSS) for patients with recurrent disease versus a matched cohort of patients with non-recurrent DTC.
  
  
  
  Of 6235 patients, 143 had treatment-defined recurrent disease. Patients with recurrent disease had inferior OS (p < .01) and CSS (p < .01). Multivariate analysis demonstrated that recurrent disease was independently associated with inferior 10-year OS (hazard ratio [HR] = 1.75; p < .01) and CSS (HR = 3.05; p < .01).
  
  
  
  Regional recurrence of DTC may negatively impact OS and CSS in patients ≥65 years old. © 2016 Wiley Periodicals, Inc. Head Neck 38: 919-924, 2016.
authors.affiliation: Department of Radiation Oncology, Emory University, Atlanta, Georgia.|Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: David M
authors.initials: DM
authors.lastname: Marcus
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia.|Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Renjian
authors.initials: R
authors.lastname: Jiang
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia.|Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Ward
authors.affiliation: Department of Radiation Oncology, Emory University, Atlanta, Georgia.|Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Higgins
authors.affiliation: Department of Hematology/Oncology, Emory University, Atlanta, Georgia.|Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Nabil F
authors.initials: NF
authors.lastname: Saba
authors.affiliation: Department of Otolaryngology, Emory University, Atlanta, Georgia.|Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: J Trad
authors.initials: JT
authors.lastname: Wadsworth
authors.affiliation: Department of Radiation Oncology, Emory University, Atlanta, Georgia.|Department of Hematology/Oncology, Emory University, Atlanta, Georgia.|Department of Otolaryngology, Emory University, Atlanta, Georgia.|Winship Cancer Institute, Emory University, Atlanta, Georgia.
authors.forename: Jonathan J
authors.initials: JJ
authors.lastname: Beitler
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D006278:Medicare; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D018426:SEER Program; D012737:Sex Factors; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000601:surgery; D014481:United States
keywords: Epidemiology; Surveillance; and End Results (SEER)-Medicare; recurrence; survival; thyroid cancer