Age increased the cancer‐specific mortality risk of thyroid cancer with lung metastasis

Abstract

Background: To investigate the relationship between age and cancer-speci c mortality in thyroid cancer (TC) with lungmetastasis.Methods: 1,418 patients with initial distant metastases from Surveillance, Epidemiology and End Results databases were investigated. Patients with median follow-up time of 8 months [interquartile range (IQR), 2-27] and median age of 66 years (IQR, were divided into ve groups by age and the association between age and TC-speci c mortality was analyzed.Results: The TC-speci c mortality rates were 32.78% (118/360), 46.71% (156/334), 53.93% (199/369), 58.96% (158/268) and 82.76% (72/87) for patients with age of ≤55 years,56-65 years, 66-75 years, 76-85 years and >85 years. Kaplan-Meier curves showed that TC-speci c mortality rate was associated with increased age (p < 0.001). Compared with patients ≤55 years, patients of 56-65 years, 66-75 years, 76-85 years and >85 years had signi cantly higher hazard ratios (HRs) of 1.69(1.26-2.26), 1.97 (1.47-2.64), 2.18(1.59-2.99) and 3.24(2.08-5.06) after adjustments for gender, tumor size and radiation therapy (all p < 0.001).In TC with initial lung-metastasis, compared with patients ≤55 years, patients of 56-65 years, 66-75 years, 76-85 years and >85 years had signi cantly higher adjusted HRs of 1.68(1.20-2.36, p=0.003), 2.18(1.57-3.02), 2.16(1.51-3.08) and 2.91(1.79-4.75) (p < 0.001). Similar results could be obtained in papillary thyroid cancer.Conclusions: The TC-speci c mortality increased with age in TC patients with initial lung-metastasis, which suggested that further risk strati cation based on age was necessary for TC over 55 years with lung-metastasis. Individual treatment strategy maybe recommended for patients over 85 years. BackgroundThyroid cancer (TC) is one of the most common endocrine tumors, and its incidence has been increasing in the past four decades(1). At present, its incidence is rising the second fasted among solid tumors and it has become the sixth most common malignancy in female population in the United States(2, 3). TC is divided into two categories according to the cell origin, one arising from endoderm-derived follicular cells, and the other arising from the neural crest-derived C-cells(4). The former category includes differentiated thyroid cancer (DTC) [papillary thyroid cancer (PTC), follicular thyroid cancer (FTC), and poorly differentiated TC], and anaplastic thyroid cancer (ATC), while the latter category is known as medullary thyroid cancer (MTC)(4). DTC accounts for approximately 90% of all thyroid cancer types.(4, 5) Clinical character of DTC is usually indolent, while ATC is the most aggressive variant, accounting for about 40% of all deaths from TC(5, 6). The most common metastatic site of TC is lung(7), followed by bone, and occasionally brain and liver(8, 9). DTC is a unique malignancy in which age at diagnosis can be an independent risk factor for prognosis (10,11). In 2016, the American Joint Committee on Cancer (AJCC) released eighth edition of the AJCC/TNM cancer staging manual, and changed the age cutof...

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“…Age, sex, and tumor size are established prognostic factors in differentiated thyroid cancer. Previous studies indicated that patients over 55 years have a poorer response to RAI therapy (32) and a worse overall prognosis (33) in thyroid cancer with lung metastases, with mortality rates increasing with age (34). Consistent with these findings, the average age of patients in RAI-refractory group were 5 years older (P <0.05) than those in RAI-avid group in the primary cohort.…”

Automatic prediction of non-iodine-avid status in lung metastases for radioactive I131 treatment in differentiated thyroid cancer patients

“…Age, sex, and tumor size are established prognostic factors in differentiated thyroid cancer. Previous studies indicated that patients over 55 years have a poorer response to RAI therapy ( 32 ) and a worse overall prognosis ( 33 ) in thyroid cancer with lung metastases, with mortality rates increasing with age ( 34 ). Consistent with these findings, the average age of patients in RAI-refractory group were 5 years older (P <0.05) than those in RAI-avid group in the primary cohort.…”

Development and validation of a nomogram for risk of pulmonary metastasis in non-papillary thyroid carcinoma: A SEER-based study

“…In a previous study, Huang et al [5] found that increasing age further influenced the occurrence and progression of PM in TC patients. Similarly, age at diagnosis was identified as an independent predictor of PM in patients with NPTC in the present study, and the mean age at disease increased by approximately 10 years in patients with NPTC who developed PM than in those who did not.…”