Predictive Factors of Thyroid Cancer in Geriatric Patients

Abstract

Aim:Although age is not a contraindication for thyroid surgery, decision for surgery should be made carefully in geriatric patients. The aim of this study was to determine the diagnostic value of cytological and ultrasonographic findings in geriatric patients with thyroid pathology.Methods:Records of patients above 65 years, who underwent thyroid surgery in our clinic between 2014 and 2019, were retrospectively analyzed. Demographic data, biopsy findings according to the Bethesda System, ultrasonography findings (nodule size, echogenicity, margin, micro-calcification, elastography values, peripheral halo and its echogenicity) and pathology results were recorded.Results:A total of 295 patients (58 males and 237 females) with the mean age of 69.13 years (range; 65-82) were included in the study. When benign and malignant groups were compared, suspicion of malignancy, presence of irregular margins, micro-calcification, elastography score of above 3, hypo-echogeneicity and hypo-echoic halo were found to be significant predictive factors for malignancy (p<0.001). When ultrasonography parameters were evaluated with regard to the malignancy risk, specificity was found to be 0.92 for micro-calcification, 0.97 for irregular contour and 0.95 for elastography score above 3.Conclusion:The indication for surgery should be supported by ultrasonography and ultrasound elastography findings in patients with atypia/follicular lesion of unknown significance or whose fine needle aspiration biopsy result is non-diagnostic.

Keywords

• thyroid cancer
• geriatric
• elastography
• irregular margins
• microcalcification