Should patient age be incorporated into Oncocytic thyroid carcinoma staging? Evidence from SEER and NCDB.

INTRODUCTION

Age is central to differentiated thyroid cancer staging, however its relevance in oncocytic thyroid carcinoma (OTC) remains unclear. We sought to identify a prognostically meaningful age threshold for OTC.

METHODS

Using SEER (2004-2022) and NCDB (2004-2020), restricted cubic splines (RCS) evaluated potential age prognostic thresholds for OTC; Cox models assessed age in relation to overall survival (OS) in both databases and disease-specific survival (DSS) in SEER.

RESULTS

Among 14,624 patients (4114 SEER; 10,510 NCDB), median age was 59 years. RCS demonstrated a linear association between age and survival, indicating that there is no prognostic age threshold. Modeled continuously, age was associated with worse adjusted OS in SEER and NCDB (HR 1.08; 95% CI 1.08-1.09; p < 0.001 for both) and worse adjusted DSS in SEER (HR 1.06; 95% CI 1.04-1.07; p < 0.001).

CONCLUSION

No discrete age threshold for survival was identified, cautioning against the use of age-based cutoffs in staging for OTC.