Defining a Valid Age Cutoff in Staging of Well-Differentiated Thyroid Cancer. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Age 45 years is used as a cutoff in the staging of well-differentiated thyroid cancer (WDTC) as it represents the median age of most datasets. The aim of this study was to determine a statistically optimized age threshold using a large dataset of patients treated at a comprehensive cancer center. METHODS: Overall, 1807 patients with a median follow-up of 109 months were included in the study. Recursive partitioning was used to determine which American Joint Committee on Cancer (AJCC) variables were most predictive of disease-specific death, and whether a different cutoff for age would be found. From the resulting tree, a new age cutoff was picked and patients were restaged using this new cutoff. RESULTS: The 10-year disease-specific survival (DSS) by Union for International Cancer Control (AJCC/UICC) stage was 99.6, 100, 96, and 81 % for stages I-IV, respectively. Using recursive partitioning, the presence of distant metastasis was the most powerful predictor of DSS. For M0 patients, age was the next most powerful predictor, with a cutoff of 56 years. For M1 patients, a cutoff at 54 years was most predictive. Having reviewed the analysis, age 55 years was selected as a more robust age cutoff than 45 years. The 10-year DSS by new stage (using age 55 years as the cutoff) was 99.2, 98, 100, and 74 % for stages I-IV, respectively. CONCLUSION: A change in age cutoff in the AJCC/UICC staging for WDTC to 55 years would improve the accuracy of the system and appropriately prevent low-risk patients being overstaged and overtreated.

publication date

  • July 28, 2015

Research

keywords

  • Adenocarcinoma
  • Adenocarcinoma, Follicular
  • Carcinoma, Papillary
  • Cell Differentiation
  • Thyroid Neoplasms

Identity

PubMed Central ID

  • PMC4959904

Scopus Document Identifier

  • 84958159601

Digital Object Identifier (DOI)

  • 10.1245/s10434-015-4762-2

PubMed ID

  • 26215199

Additional Document Info

volume

  • 23

issue

  • 2