1st Department and Clinic of General, Gastroenterological and Endocrine Surgery, Wroclaw Medical University, Wroclaw, Poland.
Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland.
Biomed Res Int. 2017;2017:1012451. doi: 10.1155/2017/1012451. Epub 2017 Oct 16.
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.
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.
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).
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.
了解老年患者甲状腺恶性肿瘤（TM）的诊断和手术指征是否与年轻患者不同，对临床医生来说似乎很有价值。
回顾性分析了 3749 例接受甲状腺肿瘤手术治疗的患者的病历。研究了经组织病理学证实为 TM（=309）患者的数据。
老年女性细胞学预测恶性肿瘤的几率是年轻女性的三倍多。老年患者手术的主要原因是压迫（<0.0001）。老年女性的恶性肿瘤最终诊断明显更高（=0.002）。临床怀疑恶性肿瘤与总女性组（=0.543，<0.001）和总男性组（=0.560，<0.001）的组织病理学诊断呈正相关。最年长 TM 患者亚组中，进展期癌症和原发性肿瘤进展的患者数量明显更多（<0.0001）。老年患者中远处转移的发生率明显更高（=0.032）。
老年女性细胞学预测恶性肿瘤的几率较高。老年患者的常见手术指征是气管压迫。老年女性的恶性肿瘤最终诊断更为常见。最年长的 TM 患者表现出更多的晚期甲状腺肿瘤和远处转移。
