Differentiated Thyroid Cancer in People Aged 85 and Older

ObjectivesTo describe the characteristics and treatment patterns of differentiated thyroid cancer in older adults. DesignRetrospective cohort study. SettingThe National Cancer Institute Surveillance, Epidemiology, and End Results database. ParticipantsIndividuals age 85 and older with a primary thyroid cancer diagnosis of papillary or follicular histology diagnosed between 1988 and 2007 (N=424). MeasurementsAge, sex, histology, extent of disease, tumor size, treatment, type of surgery, cause of death, and length of survival. ResultsTumor size and extent of disease were significantly related to cause of death (P=.02). Participants who did not have surgery were more likely to die of their thyroid cancer than of any other cause (P=.01), and whether a participant had surgery was significantly related to age (P=.002). Participants who had surgery had significantly longer survival than those who did not (P<.001). Type of surgery (P=.92) and adding radioactive iodine after surgery (P=.07) did not appear to influence length of survival. ConclusionAlthough differentiated thyroid cancer is typically considered a relatively indolent disease, this is not the case in older adults. Surgery appears to reduce the likelihood of death from thyroid cancer in this population and confers a survival benefit. Type of surgery and adding radioactive iodine therapy do not seem to improve the survival benefit of surgical management.