Links for fulltext
(May Require Subscription)
- Publisher Website: 10.1245/s10434-014-4055-1
- Scopus: eid_2-s2.0-84921024551
- PMID: 25190130
- WOS: WOS:000347817900017
- Find via
Supplementary
- Citations:
- Appears in Collections:
Article: Long-Term Outcomes for Older Patients with Papillary Thyroid Carcinoma: Should Another Age Cutoff Beyond 45 Years Be Added?
Title | Long-Term Outcomes for Older Patients with Papillary Thyroid Carcinoma: Should Another Age Cutoff Beyond 45 Years Be Added? |
---|---|
Authors | |
Issue Date | 2015 |
Publisher | Springer 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 Identifier | http://hdl.handle.net/10722/205972 |
ISSN | 2023 Impact Factor: 3.4 2023 SCImago Journal Rankings: 1.037 |
ISI Accession Number ID |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Lang, HHB | en_US |
dc.contributor.author | Lo, CY | en_US |
dc.contributor.author | Wong, KP | en_US |
dc.contributor.author | Wan, KY | en_US |
dc.date.accessioned | 2014-10-20T10:37:59Z | - |
dc.date.available | 2014-10-20T10:37:59Z | - |
dc.date.issued | 2015 | en_US |
dc.identifier.citation | Annals of Surgical Oncology, 2015, v. 22 n. 2, p. 446-453 | en_US |
dc.identifier.issn | 1068-9265 | - |
dc.identifier.uri | http://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.language | eng | en_US |
dc.publisher | Springer New York LLC. The Journal's web site is located at http://www.annalssurgicaloncology.org | - |
dc.relation.ispartof | Annals of Surgical Oncology | en_US |
dc.rights | The original publication is available at www.springerlink.com | - |
dc.title | Long-Term Outcomes for Older Patients with Papillary Thyroid Carcinoma: Should Another Age Cutoff Beyond 45 Years Be Added? | en_US |
dc.type | Article | en_US |
dc.identifier.email | Lang, HHB: Blang@hku.hk | en_US |
dc.identifier.email | Lo, CY: cylo@hkucc.hku.hk | en_US |
dc.identifier.authority | Lang, HHB=rp01828 | en_US |
dc.description.nature | postprint | - |
dc.identifier.doi | 10.1245/s10434-014-4055-1 | - |
dc.identifier.pmid | 25190130 | - |
dc.identifier.scopus | eid_2-s2.0-84921024551 | - |
dc.identifier.hkuros | 241258 | en_US |
dc.identifier.volume | 22 | en_US |
dc.identifier.issue | 2 | - |
dc.identifier.spage | 446 | - |
dc.identifier.epage | 453 | - |
dc.identifier.isi | WOS:000347817900017 | - |
dc.publisher.place | United States | - |
dc.identifier.issnl | 1068-9265 | - |