Abstract
Objective: 1) Determine the impact of age on disease-specific survival in differentiated thyroid cancer. 2) Compare the impact of age on survival between follicular and papillary thyroid cancer subtypes.
Method: The SEER Database was searched for patients with differentiated thyroid cancer between 1988-2003. Patient age, gender, tumor type, size, extension, and metastases were collected. Kaplan-Meier analyses were used to estimate disease specific survival based on age ranges. A multivariate analysis was performed to determine hazard ratios of death for various age cutoffs.
Results: A total of 42,209 patients were identified. Patients 45 years and older had significantly worse survival than younger patients (P < .001). A significant decrease in disease specific survival was first seen in patients aged 35 years and older, and survival continued to steadily decrease with each additional decade of age (P < .001). Patients aged 35 years and older were 14 times more likely to die from differentiated thyroid cancer than patients younger than 35. Age played a stronger prognotic role in death among patients with papillary carcinoma compared to follicular carcinoma.
Conclusion: Increasing age is associated with poorer survival in differentiated thyroid cancer. This relationship represents a continuum with an initial decrease in survival starting at age 35 that continues to decline with advancing age.
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