Thyroid Carcinoma Pattern Presentation According to Age

This is a retrospective study. From 2000 to 2010, 623 patients underwent thyroidectomy for cancer in our institution, with 596 enrolled. Patients were divided into groups of 10 years and then in four age subgroups (≤ 24, 25-44, 45-64, and ≥65 years) for statistical analysis. We compared age, gender, and histopathological characteristics between groups.

Results

Individuals belonging to the earlier age group presented with a highest prevalence of neuro-vascular invasion, capsular invasion and lymph node metastasis. Together with individuals of advanced age, that group also had larger tumor diameter and higher prevalence of extra-glandular disease. Even when analyzed only cases with well-differentiated carcinoma, younger individuals remain with a highest prevalence of lymph node metastasis, neuro-vascular invasion and larger tumor diameter.

Conclusion

We observed a distinct pattern of clinicopathological manifestation of thyroid cancer according to age. Individuals belonging to age extremes resemble in several pathological features, and young people usually present with more aggressive disease characteristics.

Keywords:
papillary carcinoma; thyroid neoplasms; age

		Age										p value
		≤ 24 yo		25–44 yo		45–64 yo		≥ 65 yo		Total		p value
Mean (SD)		20.15 (3.13)		35.85 (5.77)		53.27 (5.16)		71.33 (5.79)		48.14 (14.71)		–
Tumoral Diameter Median (Min-Max)		2 (0.1 - 7)		1.5 (0.1 - 7)		1.1 (0.04 - 15)		2.1 (0.1 - 12)		1.3 (0.04 - 15)		<0.001
		N	%	N	%	N	%	N	%	N	%	–
Gender	Male	5	15.1	40	19.5	51	18.9	25	28.0	121	20.3	0.235
Gender	Female	28	84.8	165	80.4	218	81.0	64	71.9	475	79.6	0.235
Histology (CA)	Papillary	26	78.7	192	93.6	248	92.1	64	71.9	530	88.9	<0.001
	Follicular	3	9.0	6	2.9	11	4.0	11	12.3	31	5.2
	Medullary	1	3.0	7	3.4	6	2.2	5	5.6	19	3.1
	PD	3	9.0	0	0.0	1	0.3	2	2.2	6	1.0
	Anaplastic	0	0.0	0	0.0	3	1.1	7	7.8	10	1.6
Neural or lymphovascular invasion		9	27.2	24	11.7	24	8.9	18	20.2	75	12.5	0.002
Multifocality		10	30.3	75	36.5	100	37.1	24	26.9	209	35.0	0.288
Gland capsule invasion		26	78.7	107	52.1	140	52.0	50	56.1	323	54.1	0.029
Extraglandular invasion		14	42.4	52	25.3	77	28.6	38	42.6	181	30.3	0.009
Positive neck LN		13	39.3	56	27.3	58	21.5	13	14.6	140	23.4	0.013
Lateral compartment positive LN		4	12.1	29	14.1	17	6.3	9	10.1	59	9.8	0.042

		Age										p value
		≤ 24 yo		25–44 yo		45–64 yo		≥ 65 yo		Total		p value
Mean (SD)		20.10 (2.79)		35.78 (5.75)		53.25 (5.20)		71.05 (5.39)		47.75 (14.32)		–
Tumoral Diameter Median (Min-Max)		1.9 (0.1 - 7)		1.5 (0.1 - 7)		1.2 (0.04 - 7.6)		1.25 (0.1 - 10)		1.3 (0.04 - 10)		<0.001
		N	%	N	%	N	%	N	%	N	%	–
Gender	Male	5	17.2	35	17.6	46	17.7	18	24.0	104	18.5	0.633
Gender	Female	24	82.7	163	82.3	213	82.2	57	76.0	457	81.4	0.633
Histology (CA)	Papillary	26	89.6	192	96.9	248	95.7	64	85.3	530	94.4	<0.001
Histology (CA)	Follicular	3	10.3	6	3.0	11	4.2	11	14.6	31	5.5	<0.001
Neural or lymphovascular invasion		8	27.5	22	11.1	21	8.1	12	16.0	63	11.2	0.007
Multifocality		9	31.0	75	37.8	99	38.2	23	30.6	206	36.7	0.574
Gland capsule invasion		22	75.8	103	52.0	134	51.7	39	52.0	298	53.1	0.097
Extraglandular invasion		12	41.3	50	25.2	73	28.1	28	37.3	163	29.0	0.111
Positive neck LN		12	41.3	51	25.7	55	21.2	9	12.0	127	22.6	0.008
Lateral compartment positive LN		4	29.0	24	12.1	15	5.7	6	8.0	49	8.7	0.081

Fundação Otorrinolaringologia R. Teodoro Sampaio, 483, 05405-000 São Paulo/SP Brasil, Tel.: (55 11) 3068-9855, Fax: (55 11) 3079-6769 - São Paulo - SP - Brazil
E-mail: iaorl@iaorl.org

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[1] Address for correspondence Fábio Muradás Girardi, MD, MSc, Department of Head and Neck Surgery, Hospital Santa Rita, Complexo Hospital Santa Casa de Porto Alegre, Independência, 354, 901 Porto Alegre, RS 90035070, Brazil (e-mail: fabiomgirardi@gmail.com).