Purpose: The incidence rate of differentiated
thyroid cancer (DTC), the most common type of
thyroid cancer, has increased in the past two decades. The present study analyzed the clinical and pathological characteristics of DTC, and discussed the risk factors for survival in elderly age-risk DTC patients. Methods: Elderly patients who were diagnosed with DTC, and subsequently underwent surgery for DTC, were identified from the SEER database (1988-2008). Based on histology, these patients were divided into C-PTC, FV-PTC, and
FTC. The clinical characteristics, pathological features, and treatments undertaken were compared among these patients. Cox proportional hazards analysis was performed to evaluate the risk factors to disease-specific survival (DSS). Results: In elderly DTC patients, FV-PTC shows intermediate
tumor features compared to C-PTC and
FTC, but presented a better outcome. Being male, African-American,
tumors sized bigger than 4 cm, extrathyroidal extension,
lymph node metastasis, and distant
metastasis, were all strong risk factors for DSS in elderly DTC patients (all p < 0.05). No difference was found between lobectomy and total
thyroidectomy with respect to DSS, and
radiation therapy conferred no apparent advantage with respect to DSS (both p > 0.05). Discussion: Patients with FV-PTC needed more specific histology cataloging and risk assessment, suggesting
conservative therapy. Risk stratification should be paid attention to, and treatment should be individualized for elderly patients.