Indications for thyroid cancer surgery in elderly patients

Abstract

Purpose: To define the indications for thyroid cancer surgery in elderly patients.

Methods: We compared the clinical characteristics of thyroid cancers in 85 elderly patients, defined as those aged > or =75 years, with those of 37 young patients, defined as those aged <30 years. The elderly group included patients who underwent surgery and/or reoperation and those managed nonoperatively. All patients were treated during an 11-year period from 1994 to 2004 at the Cancer Institute Hospital.

Results: The elderly patients with papillary thyroid carcinoma had a significantly worse cumulative 5-year survival rate than the young patients with papillary thyroid carcinoma (92% vs 100%: P = 0.03). However, there was no significant difference in the survival of patients with low-risk tumors between the two age groups. The cumulative 2-year survival rate of elderly patients with a high-risk tumor was significantly lower in patients not treated with surgery than in those treated surgically (80% vs 100%: P = 0.02). Quality of life (QOL) was severely impaired in 67% and 6% of the nonoperated and operated patients, respectively.

Conclusions: These results suggest that surgery for thyroid cancer increases the survival rate and promotes the QOL of elderly patients if they are well enough to tolerate the procedure.