Clinicopathological characteristics and recurrence risk of papillary thyroid microcarcinoma in the elderly

Background: The optimal management for elderly patients with papillary thyroid microcarcinoma (PTMC) is not well established. The aim of the present study is to describe the clinicopathological characteristics and identify predictors of recurrence in the elderly PTMC patients. Methods: We conducted a retrospective study of PTMC patients who underwent thyroidectomy. The clinicopathological characteristics were compared between patients with age >= 65 years and <65 years. The independent predictors of recurrence were identified by multivariate Cox regression analysis. Results: The patients in elderly group were more likely to exhibit bilaterality (P<0.050), extrathyroidal extension (P<0.001), and central compartment lymph node metastasis (CLNM) (P<0.010), especially the ratio of CLNM >0.5 (P<0.010), than the patients with age <65 years. The elderly patients had poorer recurrence-free survival (RFS) than those with younger ages (P=0.002). Multivariate analysis indicated tumor size >5 mm (P=0.009) and CLNM ratio >0.5 (P=0.002) were independent risk factors for recurrence of the elderly patients with PTMC. Conclusions: The elderly PTMC patients have more aggressive biological characteristics and higher recurrence rate. More aggressive treatment and rigorous follow-up could be considered for elderly patients with tumor diameter >5 mm and CLNM ratio >0.5.