Thyroid Nodule 101: Patients Over 70 Years Old. Why Operate?

Thyroid Nodule 101: Patients Over 70 Years Old. Why Operate?

Thyroid Nodule 101: Patients Over 70 Years Old. Why Operate?

Thyroid Nodule 101: Patients Over 70 Years Old. Why Operate

Comments by Dr.G.

1. 1200 > 70 year old patients with 2600 nodules.

2. 67 % of nodules were benign.

3. FNA lead to surgery in 210 patients and 93/210 were benign.

thyroid-surgery-complications

 

4.  Significant risk  thyroid cancer was reviewed anaplastic, medullary,and poorly diff thyroid cancers was only 1.5 % of the cases.All 10 cancer deaths 0.9% were from this group.

4. 160 14% died over 4 year followup from other causes.

5.1112 patients demonstrated that a separate non-thyroidal malignancy or coronary artery disease at the time of nodule evaluation was associated with increased mortality.

6.These are important variables to identify prior to thyroid nodule evaluation.

7.For patients ≥70 years old, US and FNA are safe and prove helpful in identifying significant risk cancers and benign cytology.

8.However, the surgical management of patients ≥70 years old presenting without high-risk findings should be tempered, especially when comorbid illness is identified.

9. The use of non -surgical alternatives such as ethanol and radiofrequency ablation can treat the majority of thyroid lesions in the older populations.

RFA for nodules and cancer in elderly instead of surgery.

nodules

nodules2

Ethanol ablation of thyroid and parathyroid cysts in elderly saves a surgery with it’s possible complications.

para-cyst-pei

Call 1-310-393-8860 or email to thyroid.manager@protonmail.com for an evaluation for these alternatives if you are over 70 before you go under the surgical knife.

Richard Guttler MD FACE,ECNU

43 years caring for thyroid patients with nodules;es and cancer.

310-393-8860 or thyroid.manager@proton mail.com

2 Comments
  • PB October 21, 2018 11:53 am

    Question – when this treatment (RF ablation) is successful in old age population – Is there any reason why this is not used in younger population?

    • Dr Guttler October 22, 2018 7:30 am

      PB,
      Thyroid RFA is used in any age if the patient has the indications for it.
      It is still not FDA approved for the US, but many travel to Europe and Korea for RFA treatment.
      Dr.G.

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