UC Davis School of Medicine, Sacramento, CA, USA.
Department of Surgery, The Everett Clinic, Medical Office Building, 1330 Rockefeller Avenue, Everett, WA, 98201, USA.
Clin Transl Oncol. 2017 Oct;19(10):1253-1259. doi: 10.1007/s12094-017-1663-9. Epub 2017 Apr 24.
Elderly patients may be less likely than younger patients to receive indicated therapy. We hypothesized that older patients with papillary thyroid carcinoma (PTC) would be less likely to receive total thyroidectomy (TT) than their younger counterparts.
The Surveillance, Epidemiology, and End Results database were queried for adult patients diagnosed with PTC from 2000 through 2009. Patients were categorized according to whether they received a TT or less than a total thyroidectomy (<TT). We used multivariate logistic regression to predict the use of <TT. The likelihood of undergoing <TT was reported as odds ratios (OR) with 95% confidence intervals (CI).
Of the 67,961 patients identified with PTC, 51,276 (75%) received TT, 14,750 (22%) <TT and 1935 (3%) no surgery. On multivariate analysis, advancing age increased the likelihood of receiving <TT (age 45-54 OR 1.15, CI [1.09-1.20]; age 55-64 OR 1.20, CI [1.14-1.26]; age 65-74 OR 1.40, CI [1.32-1.49]; 75-84 OR 1.80, CI [1.65-1.95]; ≥85 OR 3.01, CI [2.51-3.62], all p < 0.001).
Older patients with PTC are less likely to receive TT. Further research is needed to assess if older patients are negatively impacted by less complete surgery.
与年轻患者相比，老年患者接受指示性治疗的可能性较低。我们假设，与年轻的甲状腺乳头状癌（PTC）患者相比，老年患者接受甲状腺全切除术（TT）的可能性较低。
从 2000 年到 2009 年，对诊断为 PTC 的成年患者进行了监测、流行病学和最终结果数据库查询。根据患者是否接受 TT 或不完全甲状腺切除术（<TT）进行分类。我们使用多元逻辑回归来预测 <TT 的使用情况。<TT 的可能性以优势比（OR）和 95%置信区间（CI）报告。
在 67961 例 PTC 患者中，51276 例（75%）接受了 TT，14750 例（22%）<TT，1935 例（3%）未接受手术。在多变量分析中，年龄的增加增加了接受 <TT 的可能性（45-54 岁 OR 1.15，CI [1.09-1.20]；55-64 岁 OR 1.20，CI [1.14-1.26]；65-74 岁 OR 1.40，CI [1.32-1.49]；75-84 岁 OR 1.80，CI [1.65-1.95]；≥85 岁 OR 3.01，CI [2.51-3.62]，所有 p<0.001）。
患有 PTC 的老年患者接受 TT 的可能性较低。需要进一步研究以评估老年患者是否因手术不完整而受到负面影响。
