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- Title
The influence of age on disease outcome in 2015 ATA high-risk differentiated thyroid cancer patients.
- Authors
van Velsen, Evert F. S.; Peeters, Robin P.; Stegenga, Merel T.; van Kemenade, Folkert J.; van Ginhoven, Tessa M.; Verburg, Frederik A.; Visser, W. Edward
- Abstract
Objective: Recent research suggests that the addition of age improves the 2015 American Thyroid Association (ATA) Risk Stratification System for differentiated thyroid cancer (DTC). The aim of our study was to investigate the influence of age on disease outcome in ATA-high risk patients with a focu s on differences between patients with papillary (PTC) and follicular thyroid cancer (FTC). Methods: We retrospectively studied adult patients with high-risk DTC f rom a Dutch University hospital. Logistic regression and Cox proportional hazards models were used to est imate the effects of age (at diagnosis) and several age cutoffs (per 5 years increment between 20 and 80 years) on (i) response to therapy, (ii) developing no evidence of disease (NED), (iii) recurrence, and (iv) disease-specific morta lity (DSM). Results: We included 236 ATA high-risk patients (32% FTC) with a median follow-up of 6 years. Age, either continuously or dichotomously, had a significant influence on having an excell ent response after initial therapy, developing NED, recurrence, and DSM for PTC and FTC. For FTC, an age cutoff of 6 5 or 70 years showed the best statistical model performance, while this was 50 or 60 years for PTC. Conclusions: In a population of patients with high-risk DTC, older age has a significant negative influence on disease outcomes. Slightly different optimal age cutoffs were identified f or the different outcomes, and these cutoffs differed between PTC and FTC. Therefore, the ATA Risk Stratification Syst em may further improve should age be incorporated as an additional risk factor.
- Subjects
THYROID diseases; AGE factors in disease; THYROID cancer; PROPORTIONAL hazards models; CANCER patients; ADULTS
- Publication
European Journal of Endocrinology, 2021, Vol 185, Issue 3, p421
- ISSN
0804-4643
- Publication type
Article
- DOI
10.1530/EJE-21-0365