Replication of newly proposed TNM staging system for medullary thyroid carcinoma: a nationwide study

TY - JOUR

T1 - Replication of newly proposed TNM staging system for medullary thyroid carcinoma

T2 - a nationwide study

AU - Mathiesen, Jes Sloth

AU - Kroustrup, Jens Peter

AU - Vestergaard, Peter

AU - Poulsen, Per Løgstrup

AU - Rasmussen, Åse Krogh

AU - Feldt-rasmussen, Ulla

AU - Schytte, Sten

AU - Londero, Stefano Christian

AU - Pedersen, Henrik Baymler

AU - Hahn, Christoffer Holst

AU - Bentzen, Jens

AU - Möller, Sören

AU - Gaustadnes, Mette

AU - Rossing, Maria

AU - Nielsen, Finn Cilius

AU - Brixen, Kim

AU - Godballe, Christian

PY - 2019

Y1 - 2019

N2 - A recent study proposed new TNM groupings for better survival discrimination among stage groups for medullary thyroid carcinoma (MTC) and validated these groupings in a population-based cohort in the United States. However, it is unknown how well the groupings perform in populations outside the United States. Consequently, we conducted the first population-based study aiming to evaluate if the recently proposed TNM groupings provide better survival discrimination than the current American Joint Committee on Cancer (AJCC) TNM staging system (seventh and eighth edition) in a nationwide MTC cohort outside the United States. This retrospective cohort study included 191 patients identified from the nationwide Danish MTC cohort between 1997 and 2014. In multivariate analysis, hazard ratios for overall survival under the current AJCC TNM staging system vs the proposed TNM groupings with stage I as reference were 1.32 (95% CI: 0.38–4.57) vs 3.04 (95% CI: 1.38–6.67) for stage II, 2.06 (95% CI: 0.45–9.39) vs 3.59 (95% CI: 1.61–8.03) for stage III and 5.87 (95% CI: 2.02–17.01) vs 59.26 (20.53–171.02) for stage IV. The newly proposed TNM groupings appear to provide better survival discrimination in the nationwide Danish MTC cohort than the current AJCC TNM staging. Adaption of the proposed TNM groupings by the current AJCC TNM staging system may potentially improve accurateness in survival discrimination. However, before such an adaption further population-based studies securing external validity are needed.

AB - A recent study proposed new TNM groupings for better survival discrimination among stage groups for medullary thyroid carcinoma (MTC) and validated these groupings in a population-based cohort in the United States. However, it is unknown how well the groupings perform in populations outside the United States. Consequently, we conducted the first population-based study aiming to evaluate if the recently proposed TNM groupings provide better survival discrimination than the current American Joint Committee on Cancer (AJCC) TNM staging system (seventh and eighth edition) in a nationwide MTC cohort outside the United States. This retrospective cohort study included 191 patients identified from the nationwide Danish MTC cohort between 1997 and 2014. In multivariate analysis, hazard ratios for overall survival under the current AJCC TNM staging system vs the proposed TNM groupings with stage I as reference were 1.32 (95% CI: 0.38–4.57) vs 3.04 (95% CI: 1.38–6.67) for stage II, 2.06 (95% CI: 0.45–9.39) vs 3.59 (95% CI: 1.61–8.03) for stage III and 5.87 (95% CI: 2.02–17.01) vs 59.26 (20.53–171.02) for stage IV. The newly proposed TNM groupings appear to provide better survival discrimination in the nationwide Danish MTC cohort than the current AJCC TNM staging. Adaption of the proposed TNM groupings by the current AJCC TNM staging system may potentially improve accurateness in survival discrimination. However, before such an adaption further population-based studies securing external validity are needed.

U2 - 10.1530/EC-18-0494

DO - 10.1530/EC-18-0494

M3 - Journal article

C2 - 30550378

SN - 2049-3614

VL - 8

SP - 1

EP - 7

JO - Endocrine Connections

JF - Endocrine Connections

IS - 1

ER -