ArticleThe oncologist2024
A Proposed Modified Staging System for Medullary Thyroid Cancer: A SEER Analysis With Multicenter Validation.
Article in The oncologist, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Validation of Lymph Node Thresholds as Prognostic Factors in Medullary Thyroid Cancer Staging.Annals of surgical oncology · 2026Article
- Article
- Preoperative controlling nutritional status score for patients with medullary thyroid cancer.Endocrine · 2025Article
- Construction and validation of novel nomograms based on the log odds of positive lymph nodes to predict the prognosis of papillary thyroid cancer: a retrospective cohort study.Frontiers in endocrinology · 2025Article
- Review
- Causal relationship between gut microbiota and differentiated thyroid cancer: a two-sample Mendelian randomization study.Frontiers in oncology · 2024Article
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7 authors.
Funding
Abstract
backgroundThe 8th edition of the American Joint Committee on Cancer (AJCC) staging system for medullary thyroid cancer (MTC) was implemented in 2018. However, its ability to predict prognosis remains controversial. PATIENTS AND
methodsPatient data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database and multicenter datasets. Overall survival was the primary end-point of the present study. The concordance index (C-index) was used to assess the efficacy of various models to predict prognostic outcomes.
resultsA total of 1450 MTC patients were selected from the SEER databases and 349 in the multicenter dataset. According to the AJCC staging system, there were no significant survival differences between T4a and T4b categories (P = .299). The T4 category was thus redefined as T4a' category (≤3.5 cm) and T4b' category (>3.5 cm) based on the tumor size, which was more powerful for distinguishing the prognosis (P = .003). Further analysis showed that the T category was significantly associated with both lymph node (LN) location and count (P < .001). Therefore, the N category was modified by combining the LN location and count. Finally, the above-mentioned novel T and N categories were adopted to modify the 8th AJCC classification using the recursive partitioning analysis principle, and the modified staging system outperformed the current edition (C-index, 0.811 vs. 0.792).
conclusionsThe 8th AJCC staging system was improved based on the intrinsic relationship among the T category, LN location, and LN count, which would have a positive impact on the clinical decision-making process and appropriate surveillance.
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