title: Clinicopathological features of thyroid cancer in the elderly compared to younger counterparts: single-center experience.
abstract: OBJECTIVE
  The incidence of thyroid cancer is increased in elderly patients. It tends to be larger and have more aggressive characteristics in these patients. Our aim was to compare features of thyroid carcinoma in geriatric and non-geriatric patients.
  
  
  METHODS
  In total, 933 patients with thyroid cancer were retrospectively reviewed. Thyroid functions, ultrasonography features of malignant nodules, cytological and histopathological findings and the rates of recurrence and persistence were compared in patients ≥65 and <65 years old.
  
  
  RESULTS
  There were 153 malignant foci in 109 (11.7%) patients ≥65 and 1185 malignant foci in 824 (88.3%) patients <65 years old. Mean nodule diameter was significantly higher in geriatric patients (p = 0.008). Most of the ultrasonographical features of malignant nodules were similar in two groups. Hypoechoic halo was observed in 16.4 and 28.6% of malignant nodules in geriatric and non-geriatric group, respectively (p = 0.034). There was no significant difference in cytological diagnosis. Histopathologically, tumor diameter, rates of microcarcinomas and incidentality were similar. Of all cancer types, 88.8% in geriatric and 93.9% in non-geriatric group were papillary thyroid cancer (p = 0.028). Hurthle cell cancer constituted 3.9 and 1.1% of carcinomas in geriatric and non-geriatric patients, respectively (p = 0.015); 2.0 and 0.2% of tumors in geriatric and non-geriatric group were anaplastic, respectively (p = 0.012). Capsular and vascular invasion, extrathyroidal extension, persistence and recurrence rates were similar.
  
  
  CONCLUSIONS
  Rates of anaplastic cancer and Hurthle cell cancer which is known to have worser prognosis among other differentiated thyroid cancers are increased in geriatric ages. Cytological evaluation of thyroid nodules should strongly be considered due to increased tendency for aggressive tumor types in these patients.
authors.affiliation: Department of Endocrinology and Metabolism, Ataturk Training and Research Hospital, Universiteler Mahallesi Bilkent Caddesi No:1, 06800, Cankaya, Ankara, Turkey. drdellal@yahoo.com.
authors.forename: F D
authors.initials: FD
authors.lastname: Dellal
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Özdemir
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: A A
authors.initials: AA
authors.lastname: Tam
authors.affiliation: Department of Endocrinology and Metabolism, Ataturk Training and Research Hospital, Universiteler Mahallesi Bilkent Caddesi No:1, 06800, Cankaya, Ankara, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Baser
authors.affiliation: Department of Pathology, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Tatli Dogan
authors.affiliation: Department of Surgery, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Parlak
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: R
authors.initials: R
authors.lastname: Ersoy
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.
authors.forename: B
authors.initials: B
authors.lastname: Cakir
mesh_terms: D018263:Adenocarcinoma, Follicular / Q000473:pathology* / Q000601:surgery; D000231:Adenocarcinoma, Papillary / Q000473:pathology* / Q000601:surgery; D000368:Aged; D044963:Biopsy, Fine-Needle; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000473:pathology* / Q000601:surgery; D016606:Thyroid Nodule / Q000473:pathology* / Q000601:surgery
keywords: Cytopathology; Geriatric; Histopathology; Thyroid cancer; Ultrasonography