Oncology · Endocrinology ·
Multinational Study Proposes Refined Staging System for Medullary Thyroid Cancer
A retrospective study of 2,573 patients from 43 centers in 15 countries developed a revised staging system for medullary thyroid carcinoma (MTC). The proposed system showed stronger prognostic discrimination than AJCC TNM-8 and was also evaluated in a SEER cohort of 1,909 patients.
- Retrospective cohort included 2,573 patients across 15 countries.
- Level VII metastasis was classified as N1c.
- Proposed staging system had a higher concordance index than TNM-8.
- SEER evaluation included 1,909 patients.
This retrospective multinational study pooled data from 43 centers in 15 countries through the International Medullary Thyroid Cancer Staging Consortium. The 2,573 patients had a median age of 52 years and median follow-up of 76.3 months. Disease-specific survival was the primary endpoint. Researchers used exhaustive enumeration and multivariable Cox models to identify stage groupings for M0 disease; M1 disease remained stage IVC. Level VII metastasis was associated with poorer survival and was classified as N1c in the proposed schema.
Compared with AJCC TNM-8, the new system showed a clearer stepwise rise in disease-specific death risk across stages II, III and IV (adjusted hazard ratios 2.22, 4.81 and 15.75, respectively; all P ≤ .001). Its concordance index was 0.892, versus 0.856 for TNM-8 (P < .001). The proposed system was also evaluated in a SEER cohort of 1,909 patients.
The findings suggest improved prognostic stratification, but the system was derived retrospectively and is not reported here as an adopted staging standard. The abstract does not provide details of the SEER validation results or assess whether using the revised stages improves clinical outcomes.
In practice
For patients with medullary thyroid carcinoma, the proposed system may provide more clearly separated prognostic groups than AJCC TNM-8, including by classifying level VII metastasis as N1c. The evidence comes from a retrospective multinational cohort, with evaluation in a SEER cohort; the supplied abstract does not detail the validation results. This is a prognostic staging proposal, not evidence that changing staging practice improves outcomes, and it does not establish adoption by staging authorities.
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Journal of Clinical Oncology: International Initiative on a Refined Staging System for Medullary Thyroid Cancer: A Multinational Multicenter Study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.