Age-based disparities in the use of total thyroidectomy for papillary thyroid carcinoma.

BACKGROUND: Elderly patients may be less likely than younger patients to receive indicated therapy. We hypothesized that older patients with papillary thyroid carcinoma (PTC) would be less likely to receive total thyroidectomy (TT) than their younger counterparts.

MATERIALS AND METHODS: The Surveillance, Epidemiology, and End Results database were queried for adult patients diagnosed with PTC from 2000 through 2009. Patients were categorized according to whether they received a TT or less than a total thyroidectomy (<TT). We used multivariate logistic regression to predict the use of <TT. The likelihood of undergoing <TT was reported as odds ratios (OR) with 95% confidence intervals (CI).

RESULTS: Of the 67,961 patients identified with PTC, 51,276 (75%) received TT, 14,750 (22%) <TT and 1935 (3%) no surgery. On multivariate analysis, advancing age increased the likelihood of receiving <TT (age 45-54 OR 1.15, CI [1.09-1.20]; age 55-64 OR 1.20, CI [1.14-1.26]; age 65-74 OR 1.40, CI [1.32-1.49]; 75-84 OR 1.80, CI [1.65-1.95]; ≥85 OR 3.01, CI [2.51-3.62], all p < 0.001).

CONCLUSIONS: Older patients with PTC are less likely to receive TT. Further research is needed to assess if older patients are negatively impacted by less complete surgery.