Diagnostics of Thyroid Malignancy and Indications for Surgery in the Elderly and Younger Counterparts: Comparison of 3,749 Patients.

BACKGROUND

It seems valuable for clinicians to know if diagnostics of thyroid malignancy (TM) and indications for surgery in the elderly patients differ from these in younger counterparts.

MATERIALS AND METHODS

Retrospective analysis of the medical records of 3,749 patients surgically treated for thyroid tumor. Data of patients with histopathology confirmed TM ( = 309) were studied.

RESULTS

The rate of cytological prediction to malignancy was more than three times higher in elderly women. Compression was a main reason for surgery in the elderly ( < 0.0001). The final diagnosis of malignancy was significantly higher in older women ( = 0.002). Clinical suspicion of malignancy was positively correlated with histopathological diagnosis in total group of women ( = 0.543, < 0.001) and total group of men ( = 0.560, < 0.001). The subgroup of the eldest TM patients included a significantly higher number of subjects with advanced cancer and primary tumor progression ( < 0.0001). Distant metastases were significantly more presented among the elderly patients ( = 0.032).

CONCLUSIONS

The rate of cytological prediction to malignancy in elderly women is high. Tracheal compression is a common surgical indication in the elderly patients. The final diagnoses of malignancy predominate in elderly women. The oldest TM patients present a higher number of advanced thyroid tumors and distant metastases.