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Article: Long-Term Outcomes for Older Patients with Papillary Thyroid Carcinoma: Should Another Age Cutoff Beyond 45 Years Be Added?

TitleLong-Term Outcomes for Older Patients with Papillary Thyroid Carcinoma: Should Another Age Cutoff Beyond 45 Years Be Added?
Authors
Issue Date2015
PublisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org
Citation
Annals of Surgical Oncology, 2015, v. 22 n. 2, p. 446-453 How to Cite?
Abstract© 2014, Society of Surgical Oncology. Background: Although an age cutoff of 45 years has often been adopted to stratify cancer risk in papillary thyroid carcinoma (PTC), both cancer-specific survival (CSS) and disease-specific survival (DFS) continue to worsen beyond this cutoff. This study aimed to determine whether advanced age (i.e., >60 years) at diagnosis was an independent predictor of CSS and DFS in older (≥45 years) patients. Methods: This study analyzed 407 PTC patients with a minimal follow-up period of 7 years. Standard protocol was followed. Both CSS and DFS were estimated using the Kaplan–Meier method and compared with the log-rank test. Variables shown to be significant by the log-rank test were entered into the Cox regression analysis. Results: During a median follow-up period of 15.1 years, 51 patients (12.5 %) died of PTC, whereas 80 (20.5 %) experienced at least one recurrence. For CSS, age beyond 60 years (hazard ratio [HR], 3.027; 95 % confidence interval [CI] 1.369–6.690; p = 0.006), tumor size greater than 4 cm (HR 2.043; 95 % CI 1.141–4.255; p = 0.049), central nodal metastases (HR 2.726; 95 % CI 1.198–6.200; p = 0.017), lateral nodal metastases (HR 5.247; 95 % CI 2.987–9.216; p < 0.001), and distant metastases (HR 4.297; 95 % CI 1.726–2.506; p = 0.002) were independent predictors. For DFS, only tumor size greater than 4 cm (HR 1.733; 95 % CI 1.030–3.058; p = 0.049), central nodal metastases (HR 2.362; 95 % CI 1.010–5.523; p = 0.047), and lateral nodal metastases (HR 4.383; 95 % CI 2.388–8.042; p < 0.001) were independent predictors. Conclusions: Advanced age was an independent predictor of CSS, and cancer-related death risk showed a continuing increase beyond the age of 60 years. However, advanced age was not an independent predictor of DFS. Therefore, having another age cutoff appears justifiable for stratifying risk of cancer-related death but less justifiable for disease recurrence. Tumor size as well as central and lateral nodal metastases independently predicted CSS and DFS.
Persistent Identifierhttp://hdl.handle.net/10722/205972
ISSN
2015 Impact Factor: 3.655
2015 SCImago Journal Rankings: 1.902

 

DC FieldValueLanguage
dc.contributor.authorLang, HHBen_US
dc.contributor.authorLo, CYen_US
dc.contributor.authorWong, KPen_US
dc.contributor.authorWan, KYen_US
dc.date.accessioned2014-10-20T10:37:59Z-
dc.date.available2014-10-20T10:37:59Z-
dc.date.issued2015en_US
dc.identifier.citationAnnals of Surgical Oncology, 2015, v. 22 n. 2, p. 446-453en_US
dc.identifier.issn1068-9265-
dc.identifier.urihttp://hdl.handle.net/10722/205972-
dc.description.abstract© 2014, Society of Surgical Oncology. Background: Although an age cutoff of 45 years has often been adopted to stratify cancer risk in papillary thyroid carcinoma (PTC), both cancer-specific survival (CSS) and disease-specific survival (DFS) continue to worsen beyond this cutoff. This study aimed to determine whether advanced age (i.e., >60 years) at diagnosis was an independent predictor of CSS and DFS in older (≥45 years) patients. Methods: This study analyzed 407 PTC patients with a minimal follow-up period of 7 years. Standard protocol was followed. Both CSS and DFS were estimated using the Kaplan–Meier method and compared with the log-rank test. Variables shown to be significant by the log-rank test were entered into the Cox regression analysis. Results: During a median follow-up period of 15.1 years, 51 patients (12.5 %) died of PTC, whereas 80 (20.5 %) experienced at least one recurrence. For CSS, age beyond 60 years (hazard ratio [HR], 3.027; 95 % confidence interval [CI] 1.369–6.690; p = 0.006), tumor size greater than 4 cm (HR 2.043; 95 % CI 1.141–4.255; p = 0.049), central nodal metastases (HR 2.726; 95 % CI 1.198–6.200; p = 0.017), lateral nodal metastases (HR 5.247; 95 % CI 2.987–9.216; p < 0.001), and distant metastases (HR 4.297; 95 % CI 1.726–2.506; p = 0.002) were independent predictors. For DFS, only tumor size greater than 4 cm (HR 1.733; 95 % CI 1.030–3.058; p = 0.049), central nodal metastases (HR 2.362; 95 % CI 1.010–5.523; p = 0.047), and lateral nodal metastases (HR 4.383; 95 % CI 2.388–8.042; p < 0.001) were independent predictors. Conclusions: Advanced age was an independent predictor of CSS, and cancer-related death risk showed a continuing increase beyond the age of 60 years. However, advanced age was not an independent predictor of DFS. Therefore, having another age cutoff appears justifiable for stratifying risk of cancer-related death but less justifiable for disease recurrence. Tumor size as well as central and lateral nodal metastases independently predicted CSS and DFS.-
dc.languageengen_US
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org-
dc.relation.ispartofAnnals of Surgical Oncologyen_US
dc.rightsThe original publication is available at www.springerlink.com-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleLong-Term Outcomes for Older Patients with Papillary Thyroid Carcinoma: Should Another Age Cutoff Beyond 45 Years Be Added?en_US
dc.typeArticleen_US
dc.identifier.emailLang, HHB: Blang@hku.hken_US
dc.identifier.emailLo, CY: cylo@hkucc.hku.hken_US
dc.identifier.authorityLang, HHB=rp01828en_US
dc.description.naturepostprint-
dc.identifier.doi10.1245/s10434-014-4055-1-
dc.identifier.pmid25190130-
dc.identifier.scopuseid_2-s2.0-84921024551-
dc.identifier.hkuros241258en_US
dc.identifier.volume22en_US
dc.identifier.issue2-
dc.identifier.spage446-
dc.identifier.epage453-
dc.publisher.placeUnited States-

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