Impact of Advanced Age on the Clinical Presentation and Outcome of Sporadic Medullary Thyroid Carcinoma
by
, , and
Antonio Matrone
1, 
Carla Gambale
1,
Alessandro Prete
1,
Paolo Piaggi
2,3
,
Virginia Cappagli
1,
Valeria Bottici
1,
Cristina Romei
1,
Raffaele Ciampi
1,
Liborio Torregrossa
4,
Luigi De Napoli
5,
Eleonora Molinaro
1,
Gabriele Materazzi
5,
Fulvio Basolo
4
and
Rossella Elisei
1,* 1
Endocrine Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Via Paradisa 2, 56124 Pisa, Italy
2
National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, AZ 85016, USA
3
Department of Information Engineering, University of Pisa, 56124 Pisa, Italy
4
Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa, 56124 Pisa, Italy
5
Unit of Endocrine Surgery, Department of Surgical, Medical, Molecular Pathology and Critical Area, University Hospital of Pisa, 56124 Pisa, Italy
*
Author to whom correspondence should be addressed.
Cancers 2021, 13(1), 94; https://doi.org/10.3390/cancers13010094
Submission received: 4 December 2020
/
Revised: 25 December 2020
/
Accepted: 28 December 2020
/
Published: 30 December 2020
(This article belongs to the Special Issue Thyroid Cancer in the Elderly)
Simple Summary
The clinical behavior of medullary thyroid carcinoma is heterogeneous and can be influenced by several clinical, biochemical and molecular factors. The role of age as a prognostic factor remains controversial. In our cohort of 432 sporadic medullary thyroid carcinoma, no differences in histologic features at diagnosis and in number and type of therapies performed during the follow-up were detected when dividing the patients according to age (< and ≥ 65 years). Younger patients had a longer follow-up and survival time, compared to the older patients. However, in dead patients, no differences in the aggressiveness of the disease at presentation and treatments performed during the follow-up were found between the two age groups.
Abstract
Sporadic medullary thyroid carcinoma (MTC) is a rare malignancy with a heterogeneous clinical course. Several potential prognostic factors have been investigated, but the impact of some of these is controversial, such as age at diagnosis. We evaluated the data of 432 sporadic MTC patients followed-up for a median of 7.4 years. Patients were divided and compared according to their age at diagnosis in group A (<65 years—n = 338, 78.2%) and group B (≥65 years—n = 94, 21.8%). No differences were detected between the two groups. Median follow-up time was significantly longer in patients <65 than ≥65 years. We observed 41 (9.5%) cancer-related death events. The death rate was similar between the two age groups. However, the Kaplan Meier curve showed a longer survival time for younger patients compared to older patients [HR 2.5 (CI 95%: 1.27–4.94), p < 0.01]. Nevertheless, no differences in the aggressiveness of the disease at presentation and in the number and type of treatments performed were found in the two subgroups of dead patients. In patients with sporadic MTC, age at diagnosis did not correlate with any clinical and pathological features. Cancer-related death events are similar in older and younger patients, but survival time is longer in the younger.
Keywords:
medullary thyroid carcinoma; sporadic; age; distant metastasis; death rate
