Validation of the QTNM staging system for cancer-specific survival in patients with differentiated thyroid cancer

Mankarios, Daniel, Baade, Peter, Youl, Pip, Mortimer, Robin H., Onitilo, Adedayo A., Russell, Anthony and Doi, Suhail A. R. (2013) Validation of the QTNM staging system for cancer-specific survival in patients with differentiated thyroid cancer. Endocrine, 46 2: 300-308. doi:10.1007/s12020-013-0078-9


Author Mankarios, Daniel
Baade, Peter
Youl, Pip
Mortimer, Robin H.
Onitilo, Adedayo A.
Russell, Anthony
Doi, Suhail A. R.
Title Validation of the QTNM staging system for cancer-specific survival in patients with differentiated thyroid cancer
Journal name Endocrine   Check publisher's open access policy
ISSN 1355-008X
1559-0100
Publication date 2013-10-31
Sub-type Article (original research)
DOI 10.1007/s12020-013-0078-9
Open Access Status Not yet assessed
Volume 46
Issue 2
Start page 300
End page 308
Total pages 9
Place of publication Totowa, NJ, United States
Publisher Humana Press
Language eng
Subject 2712 Endocrinology, Diabetes and Metabolism
1310 Endocrinology
Abstract An Australian state database was used to test the validity of the Quantitative tumor/node/metastasis (QTNM) staging system for assessing prognosis of differentiated thyroid cancer (DTC) on the basis of four variables quantified at diagnosis (histopathology, age, node involvement, and tumor size). Using the Queensland Cancer Registry (QCR), we identified 788 cases of DTC diagnosed from 1982 to 2006 with complete staging information. Causes of death were ascertained by linking the QCR database with the Australian National Death Index. Subjects were staged according to AJCC TNM 7th edition and QTNM, and cancer-specific survival (CSS) was calculated by the Kaplan-Meier method. Cancer-specific mortality was observed in 22 (2.8 %) patients, with 10-year CSS for the cohort of 97.0 % at a median follow-up of 262.8 months. QTNM stage specific cancer survival at 10 years was 99.6, 97.0, and 78.6 % for low-, intermediate-, and high-risk groups, respectively. This was comparable to the original US dataset in which the QTNM was initially studied, and it fared better at discriminating survival than the standard TNM system, where there was overlap in survival between stages. The current study validates the QTNM system in an Australian cohort and shows at least equivalent discriminatory capacity to the current TNM staging system. The QTNM utilized prognostic variables of significance to produce an optimal three-stage stratification scheme. Given, its advantage in clearly discriminating between prognostic groups, clinical relevance and simplicity of use, we recommend that TNM be replaced with QTNM for risk stratification for both recurrence and CSS.
Keyword Cancer staging
Differentiated thyroid cancer
Prognosis
QTNM
TNM
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Public Health Publications
School of Medicine Publications
 
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Created: Tue, 18 Mar 2014, 23:01:14 EST by Nyree Divitini on behalf of Health LinQ