[Comparison of differentiated thyroid carcinoma staging systems in a Spanish population].
OBJECTIVE
Differentiated thyroid carcinoma staging is increasingly important due to the current trends to a less intensive therapy in low-risk patients. The TNM system is most widely used, but other systems based on follow-up of several patient cohorts have been developed. When these systems have been applied to other populations, results have been discordant. Our study evaluates the suitability of several differentiated thyroid carcinoma staging systems in a Spanish population.


METHODS
729 patients with differentiated thyroid carcinoma and staging data available were enrolled. Mean follow-up time was 10.8 years. The TNM, EORTC, AMES, Clinical class, MACIS, Ohio, NTCTCS, and Spanish systems were applied to all histological types. The Kaplan-Meier survival curves for each system were analyzed, and compared using the proportion of explained variation (PEV).


RESULTS
The demographic and clinical characteristics of our population were similar to those of other Spanish and international cohorts reported. The best systems were NTCTCS, with 74.7% PEV, and TNM (68.3%), followed by the Ohio, MACIS, EORTC, and AMES systems with minimal differences between them, while the least adequate were the Spanish (55.2%) and Clinical class (47.1%) systems.


CONCLUSIONS
The NTCTCS staging system was found to be better than TNM in our population but, because of its simplicity and greater dissemination, the TNM appears to be recommended for staging of patients with differentiated thyroid carcinoma.
Servicio de Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: vmandia@ono.com.
Víctor Manuel
VM
Andía Melero
Servicio de Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España.
María
M
Martín de Santa-Olalla Llanes
Servicio de Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España.
Marcel
M
Sambo Salas
Servicio de Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España.
Juan Carlos
JC
Percovich Hualpa
Servicio de Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España.
Marta
M
Motilla de la Cámara
Servicio de Endocrinología y Nutrición, Hospital General Universitario Gregorio Marañón, Madrid, España.
Luis
L
Collado Yurrita
D018263:Adenocarcinoma, Follicular / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000473:pathology*; D002454:Cell Differentiation; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D012189:Retrospective Studies; D013030:Spain; D013964:Thyroid Neoplasms / Q000473:pathology*; D055815:Young Adult
Carcinoma diferenciado de tiroides; Differentiated thyroid carcinoma; Sistemas de estadificación; Staging systems