PMID- 29144811
OWN - NLM
STAT- MEDLINE
DCOM- 20180731
LR  - 20230411
IS  - 1530-891X (Print)
IS  - 1530-891X (Linking)
VI  - 24
IP  - 1
DP  - 2018 Jan
TI  - CONCORDANCE OF PRE-OPERATIVE CLINICAL STAGE WITH PATHOLOGIC STAGE IN PATIENTS >/=45 
      YEARS OLD WITH WELL-DIFFERENTIATED THYROID CANCER.
PG  - 27-32
LID - 10.4158/EP-2017-0095 [doi]
AB  - OBJECTIVE: 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. METHODS: 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. RESULTS: 
      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). 
      CONCLUSION: 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. 
      ABBREVIATIONS: CI = confidence interval; cStage = clinical stage; DTC = 
      differentiated thyroid cancer; NCDB = National Cancer Data Base; OR = odds ratio; 
      pStage = pathologic stage; RAI = radioactive iodine.
FAU - Calcatera, Natalie A
AU  - Calcatera NA
FAU - Lutfi, Waseem
AU  - Lutfi W
FAU - Suman, Paritosh
AU  - Suman P
FAU - Suss, Nicholas R
AU  - Suss NR
FAU - Wang, Chi-Hsiung
AU  - Wang CH
FAU - Prinz, Richard A
AU  - Prinz RA
FAU - Winchester, David J
AU  - Winchester DJ
FAU - Moo-Young, Tricia A
AU  - Moo-Young TA
LA  - eng
PT  - Journal Article
DEP - 20171116
PL  - United States
TA  - Endocr Pract
JT  - Endocrine practice : official journal of the American College of Endocrinology 
      and the American Association of Clinical Endocrinologists
JID - 9607439
RN  - 0 (Iodine Radioisotopes)
RN  - Thyroid cancer, follicular
SB  - IM
CIN - Endocr Pract. 2018 Jan;24(1):124-125. PMID: 29144818
MH  - Adenocarcinoma, Follicular/*pathology/surgery
MH  - Aged
MH  - Aged, 80 and over
MH  - Carcinoma, Papillary/*pathology/surgery
MH  - Female
MH  - Humans
MH  - Iodine Radioisotopes/therapeutic use
MH  - Logistic Models
MH  - Male
MH  - Margins of Excision
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Neck Dissection
MH  - Neoplasm Staging
MH  - Neoplasms, Multiple Primary/*pathology/surgery
MH  - Preoperative Period
MH  - Radiotherapy, Adjuvant
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Thyroid Cancer, Papillary
MH  - Thyroid Neoplasms/*pathology/surgery
MH  - Thyroidectomy
MH  - Tumor Burden
EDAT- 2017/11/18 06:00
MHDA- 2018/08/01 06:00
CRDT- 2017/11/18 06:00
PHST- 2017/11/18 06:00 [pubmed]
PHST- 2018/08/01 06:00 [medline]
PHST- 2017/11/18 06:00 [entrez]
AID - S1530-891X(20)39350-2 [pii]
AID - 10.4158/EP-2017-0095 [doi]
PST - ppublish
SO  - Endocr Pract. 2018 Jan;24(1):27-32. doi: 10.4158/EP-2017-0095. Epub 2017 Nov 16.