Staging systems for papillary thyroid carcinoma: a study of 2 tertiary referral centers

Ann Surg. 2007 Jul;246(1):114-21. doi: 10.1097/01.sla.0000262785.46403.9b.

Abstract

Objective: To find out the most applicable and consistent staging system for papillary thyroid carcinoma (PTC) available in the literature.

Background: The commonly used staging systems for PTC have predicted cancer-specific survival (CSS) well. However, their applicability and generalizability have not yet been evaluated in different clinical settings.

Methods: A MEDLINE search from 1965 to 2005 was carried out to identify different staging systems available in the literature and 9 systems were applicable to 1634 PTC patients within 2 tertiary-referral centers. The CSS of each staging system within individual centers were calculated using Kaplan-Meier method and the CSS of each tumor stage in one individual center was compared with that of the other by log-rank test. In addition, within each center, the predictability of each staging system relative to the others was ranked based on the proportion of variation explained (PVE) value.

Results: Clinicopathologic features, treatment received, and tumor stages were significantly different between the 2 centers. There were also significant differences in CSS within at least one tumor stage between the 2 centers in 8 of the 9 staging systems. The TNM was a highly predictive and consistent staging system within the 2 centers. Although the absolute PVE values differed between the 2 centers, the relative ranking of the 9 staging systems within each center correlated significantly to each other (P < 0.05).

Conclusions: Despite referral, treatment, and data collection biases inherent within each center, the TNM system remained to be the most applicable and consistent staging system for PTC in 2 centers managing the same population group.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Papillary / mortality*
  • Carcinoma, Papillary / pathology*
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging / instrumentation
  • Prognosis
  • Referral and Consultation
  • Reproducibility of Results
  • Retrospective Studies
  • Survival Rate / trends
  • Thyroid Neoplasms / mortality*
  • Thyroid Neoplasms / pathology*
  • Time Factors
  • United States / epidemiology