Is 55 years an optimal age cutoff point for clinical staging in T1 papillary thyroid cancer?

IF 4 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Oral oncology Pub Date : 2026-01-01 Epub Date: 2025-12-11 DOI:10.1016/j.oraloncology.2025.107817

Daixing Hu , Zhuolin Dai , Yang Feng , Xinliang Su , Chun Huang

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Abstract

Background

This study aims to determine the optimal age cutoff for T1 papillary thyroid cancer (PTC), with a particular focus on the T1a and T1b subgroups.

Methods

A retrospective review of electronic medical records was conducted to identify patients who underwent thyroidectomy at our institution from January 2013 to December 2018.

Results

The study cohort consisted of 2,862 patients, including 765 men (26.7 %) and 2,097 women (73.3 %). Survival analysis demonstrated significantly poorer recurrence-free survival (RFS) in patients aged ≥55 years (p < 0.001). Patients were stratified into T1 (tumor size ≤2 cm, n = 2,328) and non-T1 (tumor size >2 cm, n = 534) subgroups. Among the non-T1 subgroup, older patients exhibited significantly inferior RFS, consistent with the overall cohort (p < 0.001). However, this difference was not observed in the T1 subgroup (p = 0.079). Within the T1 PTC subgroup, significant differences were identified between T1a and T1b patients concerning gender distribution, tumor size, clinical lymph node-positive status (cN1), total thyroidectomy, bilaterality, presence of Hashimoto’s thyroiditis, central lymph node metastasis, lateral lymph node metastasis, and radioiodine treatment (all p < 0.05). Further analysis indicated that when stratified by an age cutoff of 65 years, the prognosis for T1b patients was statistically significant (p = 0.018), whereas the prognosis for T1a patients was not statistically significant (p = 0.64).

Conclusion

The clinicopathologic characteristics of T1b patients differ significantly from those of T1a patients. Age may not be a critical factor in the prognostic staging system for T1a PTC patients, whereas 65 years appears to be a more appropriate age cutoff for T1b patients.

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55岁是T1型甲状腺乳头状癌临床分期的最佳年龄分界点吗？

本研究旨在确定T1乳头状甲状腺癌（PTC）的最佳年龄界限，特别关注T1a和T1b亚组。方法回顾性分析2013年1月至2018年12月在我院行甲状腺切除术患者的电子病历。结果研究队列包括2862例患者，其中男性765例（26.7%），女性2097例（73.3%）。生存分析显示，年龄≥55岁的患者无复发生存率（RFS）明显较差（p < 0.001）。将患者分为T1组（肿瘤大小≤2 cm， n = 2328）和非T1组（肿瘤大小≤2 cm， n = 534）。在非t1亚组中，老年患者表现出明显较差的RFS，与整个队列一致（p < 0.001）。然而，在T1亚组中没有观察到这种差异（p = 0.079）。在T1 PTC亚组中，T1a和T1b患者在性别分布、肿瘤大小、临床淋巴结阳性状态（cN1）、全甲状腺切除术、双侧、是否存在桥本甲状腺炎、中央淋巴结转移、侧淋巴结转移和放射性碘治疗方面存在显著差异（p < 0.05）。进一步分析发现，以65岁分层时，T1b患者的预后有统计学意义（p = 0.018），而T1a患者的预后无统计学意义（p = 0.64）。结论T1b患者的临床病理特征与T1a患者有显著差异。年龄可能不是T1a PTC患者预后分期系统的关键因素，而65岁似乎是T1b患者更合适的年龄界限。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral oncology 医学-牙科与口腔外科

CiteScore

8.70

自引率

10.40%

发文量

505

审稿时长

20 days

期刊介绍： Oral Oncology is an international interdisciplinary journal which publishes high quality original research, clinical trials and review articles, editorials, and commentaries relating to the etiopathogenesis, epidemiology, prevention, clinical features, diagnosis, treatment and management of patients with neoplasms in the head and neck. Oral Oncology is of interest to head and neck surgeons, radiation and medical oncologists, maxillo-facial surgeons, oto-rhino-laryngologists, plastic surgeons, pathologists, scientists, oral medical specialists, special care dentists, dental care professionals, general dental practitioners, public health physicians, palliative care physicians, nurses, radiologists, radiographers, dieticians, occupational therapists, speech and language therapists, nutritionists, clinical and health psychologists and counselors, professionals in end of life care, as well as others interested in these fields.