CONCORDANCE OF PRE-OPERATIVE CLINICAL STAGE WITH PATHOLOGIC STAGE IN PATIENTS ≥45 YEARS OLD WITH WELL-DIFFERENTIATED THYROID CANCER
Clinical stage (cStage) in thyroid cancer determines extent of surgical therapy and completeness of resection. Pathologic stage (pStage) is an important determinant of outcome. The rate of discordance between clinical and pathologic stage in thyroid cancer is unknown. The National Cancer Data Base w...
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| Veröffentlicht in: | Endocrine practice 2018-01, Vol.24 (1), p.27-32 |
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| creator | Calcatera, Natalie A Lutfi, Waseem Suman, Paritosh Suss, Nicholas R Wang, Chi-Hsiung Prinz, Richard A Winchester, David J Moo-Young, Tricia A |
| description | Clinical stage (cStage) in thyroid cancer determines extent of surgical therapy and completeness of resection. Pathologic stage (pStage) is an important determinant of outcome. The rate of discordance between clinical and pathologic stage in thyroid cancer is unknown.
The National Cancer Data Base was queried to identify 27,473 patients ≥45 years old with cStage I through IV differentiated thyroid cancer undergoing surgery from 2008-2012.
There were 16,286 (59.3%) cStage I patients; 4,825 (17.6%) cStage II; 4,329 (15.8%) cStage III; and 2,013 (7.3%) cStage IV patients. The upstage rate was 15.1%, and the downstage rate was 4.6%. For cStage II, there was a 25.5% upstage rate. The change in cStage was a result of inaccurate T-category in 40.8%, N-category in 36.3%, and both in 22.9%. On multivariate analysis, the patients more likely to be upstaged had papillary histology, tumors 2.1 to 4 cm, total thyroidectomy, nodal surgery, positive margins, or multifocal disease. Upstaged patients received radioiodine more frequently (75.3% vs. 48.1%; P |
| doi_str_mv | 10.4158/EP-2017-0095 |
| format | Article |
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The National Cancer Data Base was queried to identify 27,473 patients ≥45 years old with cStage I through IV differentiated thyroid cancer undergoing surgery from 2008-2012.
There were 16,286 (59.3%) cStage I patients; 4,825 (17.6%) cStage II; 4,329 (15.8%) cStage III; and 2,013 (7.3%) cStage IV patients. The upstage rate was 15.1%, and the downstage rate was 4.6%. For cStage II, there was a 25.5% upstage rate. The change in cStage was a result of inaccurate T-category in 40.8%, N-category in 36.3%, and both in 22.9%. On multivariate analysis, the patients more likely to be upstaged had papillary histology, tumors 2.1 to 4 cm, total thyroidectomy, nodal surgery, positive margins, or multifocal disease. Upstaged patients received radioiodine more frequently (75.3% vs. 48.1%; P<.001).
Approximately 20% of cStage is discordant to pStage. Certain populations are at risk for inaccurate staging, including cT2 and cN0 patients. Upstaged patients are more likely to receive radioactive iodine therapy.
CI = confidence interval; cStage = clinical stage; DTC = differentiated thyroid cancer; NCDB = National Cancer Data Base; OR = odds ratio; pStage = pathologic stage; RAI = radioactive iodine.</description><identifier>ISSN: 1530-891X</identifier><identifier>EISSN: 1934-2403</identifier><identifier>DOI: 10.4158/EP-2017-0095</identifier><identifier>PMID: 29144811</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Adenocarcinoma, Follicular - pathology ; Adenocarcinoma, Follicular - surgery ; Age ; Aged ; Aged, 80 and over ; Carcinoma, Papillary - pathology ; Carcinoma, Papillary - surgery ; Disease ; Ethnicity ; Female ; Histology ; Humans ; Iodine ; Iodine Radioisotopes - therapeutic use ; Logistic Models ; Lymphatic system ; Male ; Margins of Excision ; Medical prognosis ; Metastasis ; Middle Aged ; Multivariate Analysis ; Neck Dissection ; Neoplasm Staging ; Neoplasms, Multiple Primary - pathology ; Neoplasms, Multiple Primary - surgery ; Preoperative Period ; Radiotherapy, Adjuvant ; Retrospective Studies ; Risk Factors ; Surgery ; Thyroid cancer ; Thyroid Cancer, Papillary ; Thyroid Neoplasms - pathology ; Thyroid Neoplasms - surgery ; Thyroidectomy ; Tumor Burden ; Tumors ; Ultrasonic imaging</subject><ispartof>Endocrine practice, 2018-01, Vol.24 (1), p.27-32</ispartof><rights>Copyright Allen Press Publishing Services Jan 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c319t-f6d444372178ae20bfd72b56deb6a1ec1252afa62d638d45a718fce08f5cdaba3</citedby><cites>FETCH-LOGICAL-c319t-f6d444372178ae20bfd72b56deb6a1ec1252afa62d638d45a718fce08f5cdaba3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1992605738?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29144811$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Calcatera, Natalie A</creatorcontrib><creatorcontrib>Lutfi, Waseem</creatorcontrib><creatorcontrib>Suman, Paritosh</creatorcontrib><creatorcontrib>Suss, Nicholas R</creatorcontrib><creatorcontrib>Wang, Chi-Hsiung</creatorcontrib><creatorcontrib>Prinz, Richard A</creatorcontrib><creatorcontrib>Winchester, David J</creatorcontrib><creatorcontrib>Moo-Young, Tricia A</creatorcontrib><title>CONCORDANCE OF PRE-OPERATIVE CLINICAL STAGE WITH PATHOLOGIC STAGE IN PATIENTS ≥45 YEARS OLD WITH WELL-DIFFERENTIATED THYROID CANCER</title><title>Endocrine practice</title><addtitle>Endocr Pract</addtitle><description>Clinical stage (cStage) in thyroid cancer determines extent of surgical therapy and completeness of resection. Pathologic stage (pStage) is an important determinant of outcome. The rate of discordance between clinical and pathologic stage in thyroid cancer is unknown.
The National Cancer Data Base was queried to identify 27,473 patients ≥45 years old with cStage I through IV differentiated thyroid cancer undergoing surgery from 2008-2012.
There were 16,286 (59.3%) cStage I patients; 4,825 (17.6%) cStage II; 4,329 (15.8%) cStage III; and 2,013 (7.3%) cStage IV patients. The upstage rate was 15.1%, and the downstage rate was 4.6%. For cStage II, there was a 25.5% upstage rate. The change in cStage was a result of inaccurate T-category in 40.8%, N-category in 36.3%, and both in 22.9%. On multivariate analysis, the patients more likely to be upstaged had papillary histology, tumors 2.1 to 4 cm, total thyroidectomy, nodal surgery, positive margins, or multifocal disease. Upstaged patients received radioiodine more frequently (75.3% vs. 48.1%; P<.001).
Approximately 20% of cStage is discordant to pStage. Certain populations are at risk for inaccurate staging, including cT2 and cN0 patients. Upstaged patients are more likely to receive radioactive iodine therapy.
CI = confidence interval; cStage = clinical stage; DTC = differentiated thyroid cancer; NCDB = National Cancer Data Base; OR = odds ratio; pStage = pathologic stage; RAI = radioactive iodine.</description><subject>Adenocarcinoma, Follicular - pathology</subject><subject>Adenocarcinoma, Follicular - surgery</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Carcinoma, Papillary - pathology</subject><subject>Carcinoma, Papillary - surgery</subject><subject>Disease</subject><subject>Ethnicity</subject><subject>Female</subject><subject>Histology</subject><subject>Humans</subject><subject>Iodine</subject><subject>Iodine Radioisotopes - therapeutic use</subject><subject>Logistic Models</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Margins of Excision</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Neck Dissection</subject><subject>Neoplasm Staging</subject><subject>Neoplasms, Multiple Primary - pathology</subject><subject>Neoplasms, Multiple Primary - surgery</subject><subject>Preoperative Period</subject><subject>Radiotherapy, Adjuvant</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Thyroid cancer</subject><subject>Thyroid Cancer, Papillary</subject><subject>Thyroid Neoplasms - pathology</subject><subject>Thyroid Neoplasms - surgery</subject><subject>Thyroidectomy</subject><subject>Tumor Burden</subject><subject>Tumors</subject><subject>Ultrasonic imaging</subject><issn>1530-891X</issn><issn>1934-2403</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkc1um0AUhUdVoyZ1u-u6GqmbLDrJ3PmBYYlgHI-EAGFaNys0wCAlsmMH4kUeIIs-SF8sTxKInS6yuldH3z3nSgehb0AvBEh1qXPCKPiE0kB-QGcQcEGYoPzjuEtOiQrgzyn6PAy3lDIagPqETlkAQiiAM_QUZWmUFXGYRhpnc5wXmmS5LsLS_NY4SkxqojDByzK80nhlygXOw3KRJdmViY6qSSfN6LRc4ue__4TE1zosljhL4sPFSicJic18rosRMmGpY1wurovMxDiagosv6KSz68F9Pc4Z-jXXZbQgrzlhQhoOwQPpvFYIwX0GvrKO0bprfVZLr3W1Z8E1wCSznfVY63HVCml9UF3jqOpk09ra8hk6P_ju-u393g0P1eZmaNx6be_cdj9UEHge4wwoG9Ef79Db7b6_G78bqYB5VPpcjdTPA9X022HoXVft-puN7R8roNVUT6XzaqqnmuoZ8e9H0329ce1_-K0P_gJ5Nn_Y</recordid><startdate>201801</startdate><enddate>201801</enddate><creator>Calcatera, Natalie A</creator><creator>Lutfi, Waseem</creator><creator>Suman, Paritosh</creator><creator>Suss, Nicholas R</creator><creator>Wang, Chi-Hsiung</creator><creator>Prinz, Richard A</creator><creator>Winchester, David J</creator><creator>Moo-Young, Tricia A</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>201801</creationdate><title>CONCORDANCE OF PRE-OPERATIVE CLINICAL STAGE WITH PATHOLOGIC STAGE IN PATIENTS ≥45 YEARS OLD WITH WELL-DIFFERENTIATED THYROID CANCER</title><author>Calcatera, Natalie A ; Lutfi, Waseem ; Suman, Paritosh ; Suss, Nicholas R ; Wang, Chi-Hsiung ; Prinz, Richard A ; Winchester, David J ; Moo-Young, Tricia A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c319t-f6d444372178ae20bfd72b56deb6a1ec1252afa62d638d45a718fce08f5cdaba3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adenocarcinoma, Follicular - pathology</topic><topic>Adenocarcinoma, Follicular - surgery</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Carcinoma, Papillary - pathology</topic><topic>Carcinoma, Papillary - surgery</topic><topic>Disease</topic><topic>Ethnicity</topic><topic>Female</topic><topic>Histology</topic><topic>Humans</topic><topic>Iodine</topic><topic>Iodine Radioisotopes - therapeutic use</topic><topic>Logistic Models</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Margins of Excision</topic><topic>Medical prognosis</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Neck Dissection</topic><topic>Neoplasm Staging</topic><topic>Neoplasms, Multiple Primary - pathology</topic><topic>Neoplasms, Multiple Primary - surgery</topic><topic>Preoperative Period</topic><topic>Radiotherapy, Adjuvant</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Thyroid cancer</topic><topic>Thyroid Cancer, Papillary</topic><topic>Thyroid Neoplasms - 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Academic</collection><jtitle>Endocrine practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Calcatera, Natalie A</au><au>Lutfi, Waseem</au><au>Suman, Paritosh</au><au>Suss, Nicholas R</au><au>Wang, Chi-Hsiung</au><au>Prinz, Richard A</au><au>Winchester, David J</au><au>Moo-Young, Tricia A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CONCORDANCE OF PRE-OPERATIVE CLINICAL STAGE WITH PATHOLOGIC STAGE IN PATIENTS ≥45 YEARS OLD WITH WELL-DIFFERENTIATED THYROID CANCER</atitle><jtitle>Endocrine practice</jtitle><addtitle>Endocr Pract</addtitle><date>2018-01</date><risdate>2018</risdate><volume>24</volume><issue>1</issue><spage>27</spage><epage>32</epage><pages>27-32</pages><issn>1530-891X</issn><eissn>1934-2403</eissn><abstract>Clinical stage (cStage) in thyroid cancer determines extent of surgical therapy and completeness of resection. Pathologic stage (pStage) is an important determinant of outcome. The rate of discordance between clinical and pathologic stage in thyroid cancer is unknown.
The National Cancer Data Base was queried to identify 27,473 patients ≥45 years old with cStage I through IV differentiated thyroid cancer undergoing surgery from 2008-2012.
There were 16,286 (59.3%) cStage I patients; 4,825 (17.6%) cStage II; 4,329 (15.8%) cStage III; and 2,013 (7.3%) cStage IV patients. The upstage rate was 15.1%, and the downstage rate was 4.6%. For cStage II, there was a 25.5% upstage rate. The change in cStage was a result of inaccurate T-category in 40.8%, N-category in 36.3%, and both in 22.9%. On multivariate analysis, the patients more likely to be upstaged had papillary histology, tumors 2.1 to 4 cm, total thyroidectomy, nodal surgery, positive margins, or multifocal disease. Upstaged patients received radioiodine more frequently (75.3% vs. 48.1%; P<.001).
Approximately 20% of cStage is discordant to pStage. Certain populations are at risk for inaccurate staging, including cT2 and cN0 patients. Upstaged patients are more likely to receive radioactive iodine therapy.
CI = confidence interval; cStage = clinical stage; DTC = differentiated thyroid cancer; NCDB = National Cancer Data Base; OR = odds ratio; pStage = pathologic stage; RAI = radioactive iodine.</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>29144811</pmid><doi>10.4158/EP-2017-0095</doi><tpages>6</tpages></addata></record> |
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| subjects | Adenocarcinoma, Follicular - pathology Adenocarcinoma, Follicular - surgery Age Aged Aged, 80 and over Carcinoma, Papillary - pathology Carcinoma, Papillary - surgery Disease Ethnicity Female Histology Humans Iodine Iodine Radioisotopes - therapeutic use Logistic Models Lymphatic system Male Margins of Excision Medical prognosis Metastasis Middle Aged Multivariate Analysis Neck Dissection Neoplasm Staging Neoplasms, Multiple Primary - pathology Neoplasms, Multiple Primary - surgery Preoperative Period Radiotherapy, Adjuvant Retrospective Studies Risk Factors Surgery Thyroid cancer Thyroid Cancer, Papillary Thyroid Neoplasms - pathology Thyroid Neoplasms - surgery Thyroidectomy Tumor Burden Tumors Ultrasonic imaging |
| title | CONCORDANCE OF PRE-OPERATIVE CLINICAL STAGE WITH PATHOLOGIC STAGE IN PATIENTS ≥45 YEARS OLD WITH WELL-DIFFERENTIATED THYROID CANCER |
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