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

作者：Kaliszewski Krzysztof; Diakowska Dorota; Strutynska Karpinska Marta; Wojtczak Beata; Aporowicz Michal; Forkasiewicz ZdzisBaw; Balcerzak Waldemar; Lukienczuk Tadeusz; Domoslawski Pawel

来源：Biomed Research International, 2017, 2017: 1012451.

DOI：10.1155/2017/1012451

<jats:p><jats:italic>Background</jats:italic>. 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.<jats:italic> Materials and Methods</jats:italic>. Retrospective analysis of the medical records of 3,749 patients surgically treated for thyroid tumor. Data of patients with histopathology confirmed TM (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M1"><mml:mi>n</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">309</mml:mn></mml:math>) were studied.<jats:italic> Results.</jats:italic> 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 (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:mi>p</mml:mi><mml:mo>&lt;</mml:mo><mml:mn fontstyle="italic">0.0001</mml:mn></mml:math>). The final diagnosis of malignancy was significantly higher in older women (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M3"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.002</mml:mn></mml:math>). Clinical suspicion of malignancy was positively correlated with histopathological diagnosis in total group of women (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M4"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.543</mml:mn></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M5"><mml:mi>p</mml:mi><mml:mo>&lt;</mml:mo><mml:mn fontstyle="italic">0.001</mml:mn></mml:math>) and total group of men (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M6"><mml:mi>r</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.560</mml:mn></mml:math>, <mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M7"><mml:mi>p</mml:mi><mml:mo>&lt;</mml:mo><mml:mn fontstyle="italic">0.001</mml:mn></mml:math>). The subgroup of the eldest TM patients included a significantly higher number of subjects with advanced cancer and primary tumor progression (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M8"><mml:mi>p</mml:mi><mml:mo>&lt;</mml:mo><mml:mn fontstyle="italic">0.0001</mml:mn></mml:math>). Distant metastases were significantly more presented among the elderly patients (<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M9"><mml:mi>p</mml:mi><mml:mo>=</mml:mo><mml:mn fontstyle="italic">0.032</mml:mn></mml:math>).<jats:italic> Conclusions</jats:italic>. 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.</jats:p>

• 出版日期2017