Evaluating the predicted impact of changes to the AJCC/TMN staging system for differentiated thyroid cancer (DTC): A prospective observational study of patients in South East Scotland

• DOI: 10.1111/coa.13300
• Publication Date: 2019-02-05T17:52:27Z
• Authors: Kate Hulse; Adam Williamson; Fraser W. Gibb; Brendan Conn; Iain J. Nixon
• Keywords: Adult; Aged, 80 and over; Male; Time Factors; Adolescent; Thyroid Gland; Adenocarcinoma; Middle Aged; Prognosis; 3. Good health; Survival Rate; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Scotland; Predictive Value of Tests; Humans; Female; Prospective Studies; Thyroid Neoplasms; Aged; Follow-Up Studies; Neoplasm Staging

Abstract Objectives To assess the impact of eighth edition AJCC/TMN staging system on patients with new diagnoses differentiated thyroid cancers presenting to our regional multidisciplinary team meetings. Design We analysed Endocrine Cancer MDT meeting records from 2009 2015 identify all in region a diagnosis cancer. re‐staged according AJCC/TNM classification and survival outcomes each stage under seventh systems. Setting Tertiary referral centre South East Scotland (NHS Lothian). Participants Three hundred sixty‐one were newly diagnosed DTC within during study period met inclusion criteria. Main outcome measures: Disease‐specific mortality at any time follow‐up. Results In total, 119 361 (33%) when was applied. The number classified as having advanced (III/IV) disease fell 76 (21%) 8 (2%). most common reason for down‐staging re‐classification tumour size, factor 96 (80.7%) down‐staged patients. five‐year disease‐specific cohort overall 98%. Overall, 7 (1.9%) cancer–related deaths occurred follow‐up, three whom down‐staged. Conclusions On implementation system, we expect many who would previously have been considered cancer will now be early stage. This accurately reflect their excellent outcomes.