title: Observation versus thyroidectomy for papillary thyroid microcarcinoma in the elderly.
abstract: OBJECTIVE
  To compare the effectiveness of non-surgical versus surgical therapy in elderly patients with papillary thyroid microcarcinoma.
  
  
  METHODS
  The study cohort included 2323 elderly patients (aged 65 years and over) diagnosed with papillary thyroid microcarcinoma between 1988 and 2009, identified in the Surveillance, Epidemiology, and End Results 18 database of the National Cancer Institute.
  
  
  RESULTS
  The five-year overall survival rate was 23 per cent for non-surgical patients compared with 91 per cent for surgical patients (p < 0.0001). Unadjusted analysis revealed significantly improved survival in surgical patients compared with non-surgical patients (hazard ratio = 0.06; p < 0.0001). Propensity score analysis also revealed significantly improved survival in surgical patients compared with non-surgical patients (hazard ratio = 0.11; p < 0.0001).
  
  
  CONCLUSIONS
  Thyroidectomy appears to provide a survival benefit for elderly patients with papillary thyroid microcarcinoma. High-quality prospective studies are needed to better evaluate the comparative effectiveness of immediate thyroidectomy versus observation for elderly patients with papillary thyroid microcarcinoma.
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery,Stanford University School of Medicine,California,USA.
authors.forename: U C
authors.initials: UC
authors.lastname: Megwalu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000401:mortality / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D011379:Prognosis; D057216:Propensity Score; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018426:SEER Program; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000401:mortality / Q000628:therapy*; D013965:Thyroidectomy; D057832:Watchful Waiting
keywords: Aged; SEER Program; Thyroid Neoplasms; Thyroidectomy