Evaluating the use of a two-step age-based cutoff for the UICC/AJCC TNM staging system in patients with papillary or follicular thyroid cancer
| Autor: | Evert F S van Velsen, Robin P Peeters, Merel T Stegenga, Uwe Mäder, Christoph Reiners, F J van Kemenade, Tessa M van Ginhoven, W Edward Visser, Frederik Anton Verburg |
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| Přispěvatelé: | Internal Medicine, Pathology, Surgery, Radiology & Nuclear Medicine |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Databases Factual Endocrinology Diabetes and Metabolism Age Factors General Medicine Middle Aged Disease-Free Survival Cohort Studies Endocrinology SDG 3 - Good Health and Well-being Thyroid Cancer Papillary Germany Adenocarcinoma Follicular Humans Female Thyroid Neoplasms Aged Neoplasm Staging Netherlands Retrospective Studies |
| Zdroj: | European Journal of Endocrinology, 186(3), 389-397. Bioscientifica Ltd |
| ISSN: | 1479-683X 0804-4643 |
| Popis: | Background The joint Union International Contre le Cancer and American Joint Committee on Cancer (UICC/AJCC) Tumor, Node, Metastasis (TNM) staging system for differentiated thyroid cancer (DTC) involves a single age cutoff as a prognostic criterion. Because a single cutoff is a dichotomization of what might be a sliding scale, using multiple age cutoffs might result into a better stage definition. The aim of our study was to investigate if using a two-step age-based cutoff would improve the TNM staging system regarding disease-specific survival (DSS). Methods We retrospectively studied two cohorts of adult DTC patients from The Netherlands and Germany. DSS was analyzed for papillary (PTC) and follicular thyroid cancer (FTC) separately, investigating several two-step age-based cutoffs for those with distant metastases; below lower threshold classified as stage I, between lower and upper threshold as stage II, and above upper threshold as stage IV. Results We included 3074 DTC patients (77% PTC). For PTC, an age cutoff of 45 with 50 years had the best statistical model performance, while this was 25 with 40 years for FTC. However, differences with the optimal single age cutoffs of 50 years for PTC and 40 years for FTC were small. Conclusions The optimal two-step age-based cutoff to predict DSS is 45 with 50 years for PTC and 25 with 40 years for FTC, rather than 55 years currently used for DTC. Although these two-step age-based cutoffs were marginally better from a statistical point of view, from a clinical point of view, the recently defined optimal single age cutoffs of 50 years for PTC and 40 years for FTC might be preferable. |
| Databáze: | OpenAIRE |
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