Simplified Method Has Value for Prognosis in Thyroid Cancer-- Eric Metcalf
Monday, March 16, 2009
MONDAY, March 16 (HealthDay News) -- A quantified alternative to the TNM system -- a cancer-staging system using tumor size, node involvement and presence of metastases -- provides a simple method of predicting recurrence and cancer-specific mortality, with no loss of discrimination compared to other systems, for differentiated thyroid carcinoma, according to research published online March 9 in the Journal of Clinical Oncology.
Adedayo A. Onitilo, M.D., of the Marshfield Clinic Weston Center in Weston, Wis., and colleagues used data from 614 cases of differentiated thyroid carcinoma to create the quantified TNM (QTNM) score. Patients received points for age older than 45, neck nodal metastases, tumor size larger than 4 centimeters or extrathyroidal extension, and non-papillary disease. Patients were then put into low-, intermediate- and high-risk groups.
The QTNM showed similar or better discrimination compared with the conventional TNM system and the MACIS (Mayo Clinic's metastasis, age, completeness, invasive, size score) and M.D. Anderson classifications, and also performed well when applied to a validation cohort, the researchers report.
"The QTNM results suggest that despite being a simple and easily applied quantitative score, it retains a similar prognostic significance to the TNM, MACIS, and M.D. Anderson classifications. At the same time, it obviates the necessity to make use of the bins in the complicated fashion of grouping them together into larger bins called stages for clinical use as dictated by the TNM classification," the authors write, referring to "bins" as a method of partitioning patients into groups to predict survival.
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