BACKGROUND: Tumor, node, and metastasis staging in thyroid carcinoma is important for assessing prognosis. However, patients with stage III or IV disease have an overall survival rate of 90%. The change to 55 years of age as the cutoff will create stage migration and many patients will be downstaged. METHODS: We reviewed our database of 3,650 patients to analyze the impact of the new American Joint Committee on Cancer staging system. There were 994 men (27%) and 2,656 women (73%). The median age was 46 years. Patients were staged using both 7th and 8th editions, with a cutoff of 55 years of age and new definitions of T3 and T4, and nodal staging. RESULTS: Of 3,650 patients, 1,057 (29%) were downstaged. There were 104 (10%) who went from stage IV to I, 109 (10%) who went from stage IV to stage II, and 68 (6%) who went to stage III. There were 218 (21%) who went from stage III to I, 347 (33%) who went from stage III to stage II, and 211 (20%) who went from stage II to I. The overall disease-specific and relapse-free survival was analyzed and showed better stratification with the new staging system. CONCLUSION: The new staging system reflects more appropriately the biology of thyroid cancer and will have significant impact on the management of thyroid cancer.
BACKGROUND:Tumor, node, and metastasis staging in thyroid carcinoma is important for assessing prognosis. However, patients with stage III or IV disease have an overall survival rate of 90%. The change to 55 years of age as the cutoff will create stage migration and many patients will be downstaged. METHODS: We reviewed our database of 3,650 patients to analyze the impact of the new American Joint Committee on Cancer staging system. There were 994 men (27%) and 2,656 women (73%). The median age was 46 years. Patients were staged using both 7th and 8th editions, with a cutoff of 55 years of age and new definitions of T3 and T4, and nodal staging. RESULTS: Of 3,650 patients, 1,057 (29%) were downstaged. There were 104 (10%) who went from stage IV to I, 109 (10%) who went from stage IV to stage II, and 68 (6%) who went to stage III. There were 218 (21%) who went from stage III to I, 347 (33%) who went from stage III to stage II, and 211 (20%) who went from stage II to I. The overall disease-specific and relapse-free survival was analyzed and showed better stratification with the new staging system. CONCLUSION: The new staging system reflects more appropriately the biology of thyroid cancer and will have significant impact on the management of thyroid cancer.
Authors: Iain J Nixon; Laura Y Wang; Jocelyn C Migliacci; Antoine Eskander; Michael J Campbell; Ahmad Aniss; Lilah Morris; Fernanda Vaisman; Rossana Corbo; Denise Momesso; Mario Vaisman; Andre Carvalho; Diana Learoyd; William D Leslie; Richard W Nason; Deborah Kuk; Volkert Wreesmann; Luc Morris; Frank L Palmer; Ian Ganly; Snehal G Patel; Bhuvanesh Singh; R Michael Tuttle; Ashok R Shaha; Mithat Gönen; K Alok Pathak; Wen T Shen; Mark Sywak; Luis Kowalski; Jeremy Freeman; Nancy Perrier; Jatin P Shah Journal: Thyroid Date: 2016-02-25 Impact factor: 6.568
Authors: D P Byar; S B Green; P Dor; E D Williams; J Colon; H A van Gilse; M Mayer; R J Sylvester; M van Glabbeke Journal: Eur J Cancer Date: 1979-08 Impact factor: 9.162
Authors: Mohamed Abdelgadir Adam; John Pura; Paolo Goffredo; Michaela A Dinan; Shelby D Reed; Randall P Scheri; Terry Hyslop; Sanziana A Roman; Julie A Sosa Journal: J Clin Oncol Date: 2015-06-15 Impact factor: 44.544
Authors: William F McNamara; Laura Y Wang; Frank L Palmer; Iain J Nixon; Jatin P Shah; Snehal G Patel; Ian Ganly Journal: Surgery Date: 2016-03-16 Impact factor: 3.982