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Geriatric Principles Affect Thyroid Disease Treatment

“The burden of surgical thyroid disease, particularly cancer, is increasing. This is paralleled by increased longevity in the population and increased prevalence of thyroid disease in the older adults,” said Kourosh Parham, MD, PhD. “In most communities around the U.S., otolaryngologists are performing an increasing majority of thyroid surgeries. Therefore, we need to position ourselves to provide the best care to every segment of our patient populations, including the geriatric patients.”

The geriatric population is rapidly increasing, with the number of people aged 85 and older projected to increase 350 percent by 2050. Both benign and malignant thyroid diseases present across the lifespan. Geriatric presentations and management, however, differ from those in the younger population and are influenced by age-related comorbidities, such as frailty. To optimize treatment outcomes, dissemination of geriatric-specific information is needed. 

Kourosh Parham, MD, PhD

“Surgery in older adults involves nuances that may not be readily apparent to the medical community,” said Dr. Parham, who will be moderating Tuesday’s Panel Presentation.  “Successful surgery in the older patient involves optimal preparation, including recognition and management of the geriatric-specific risk factors pre-, intra- and postoperatively.  While general guidelines are emerging from various organizations such as the American College of Surgeons (ACS) and the American Geriatric Society (AGS), these guidelines need to be placed in the context of specific diseases and surgery.  Our expert panel is the first step in that direction for endocrine surgery in the elderly.”

Dr. Parham, of the University of Connecticut, will address the characteristics and treatment patterns of differentiated thyroid cancer in older adults using SEER Database and ACS guidelines on pre-/perioperative surgical care of older adults. He will also provide an update on the upcoming NSQIP recommendations from the ACS/AGS Coalition for Quality for Geriatric Surgery. In addition, David J. Terris, MD, of Augusta University, will discuss safety of surgical management; David C. Shonka, Jr., MD, of the University of Virginia, will address vitamin D status/post-op hypoparathyroidism; and Michael C. Singer, MD, of Henry Ford Hospital, will present on perioperative thyroid hormonal considerations.

Surgical Management of Thyroid Disease and Cancer in the Geriatric Population: Parts I and II

Today, 3:45 – 4:45 pm, Part I;
5:00 – 6:00 pm, Part II

GWCC, Building B, Room 306

“The main objective of this session is to build increased awareness of geriatric principles such as frailty and cognitive decline in the otolaryngology community so that it will influence surgical decision-making and treatment in the context of thyroid disorders,” Dr. Parham said. “Our hope is that this effort will not only aid in improving the safety of geriatric thyroid surgery, but also facilitate postoperative recovery without setbacks.”