Impact of age on survival in radioiodine refractory differentiated thyroid cancer patients

in European Journal of Endocrinology
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  • 1 Thyroid and Endocrine Tumors Unit, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
  • 2 Oncology Department, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
  • 3 GRC n°16, GRC Tumeurs Thyroïdiennes, Sorbonne Universite, Paris, Ile de France, France
  • 4 Department of Surgery, Sorbonne Universite, Pitié-Salpêtrière Hospital APHP, Paris, Ile de France, France
  • 5 INSERM, Sorbonne Université, Institut Pierre Louis d’Epidémiologie et de Santé Publique IPLESP, AP-HP, Hôpitaux Universitaires Pitié Salpêtrière – Charles Foix, Paris, Ile de France, France

Correspondence should be addressed to C Buffet; Email: camille.buffet@aphp.fr

Objective

The objectives of our study were to analyze the influence of age on the survival of patients with RAIR-DTC and to determine their prognostic factors according to age.

Methods

This single-center, retrospective study enrolled 155 patients diagnosed with RAIR-DTC. The primary end point was overall survival (OS) according to different cutoff (45, 55, 65, 75 years). Secondary endpoints were progression free survival (PFS) and prognostic factors in patients under and over 65 years.

Results

Median OS after RAIR diagnosis was 8.2 years (95% IC: 5.3–9.6). There was no difference according to age with a 65 (P = 0.47) and 55 years old cutoff (P = 0.28). Median OS improved significantly before 45 years old (P = 0.0043). After 75 years old, median OS significantly decreased (P = 0.0008). Median PFS was 2.1 years (95% CI: 0.8–3) in patients < 65 years old, and 1 year in patients ≥ 65 years old (95% CI: 0.8–1.55) with no statistical difference (P = 0.22). There was no impact of age on PFS with any cutoff. In both groups, progressive disease despite 131I treatment reduced OS. In patients < 65 years old, an interval of less than 3 years between the initial diagnosis and the diagnosis of RAIR metastatic disease was predictive of poor survival. In patients > 65 years old, the presence of a mediastinum metastasis was a significant factor for mortality (HR: 4.55, 95% CI: 2.27–9.09).

Conclusion

In RAIR-DTC patients, a cut-off age of 65 years old was not a significant predictive factor of survival. Forty-five and 75-years-old cutoff were predictive for OS but not PFS.

 

     European Society of Endocrinology

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