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

Eur J Endocrinol. 2021 Mar 1:EJE-20-1073.R3. doi: 10.1530/EJE-20-1073. Online ahead of print.

ABSTRACT

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 centre, retrospective study enrolled 155 patients diagnosed with RAIR-DTC. The primary end point was overall survival (OS) according to different cut-off (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 cut-off (p=0.28). Median OS was significantly improved before 45 years old (p=0,0043). After 75 years old, median OS significantly decrease (p= 0,0008). Median PFS was 2.1 years (95% CI: 0.8-3) in patients < 65 years, and 1 year in patients ≥ 65 years (95% CI: 0.8-1.55) with no statistical difference (p=0.22). There was no impact of age on PFS with any cut-off. In both groups, progressive disease despite 131I treatment reduced OS. In patients < 65, 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, 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. 45 and 75 years old cut off were predictive for OS, but not PFS.

PMID:33667193 | DOI:10.1530/EJE-20-1073

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