Eliminating the Age Cutoff in Staging of Differentiated Thyroid Cancer: The Safest Road?.

Eliminating the Age Cutoff in Staging of Differentiated Thyroid Cancer: The Safest Road?. - 2018

Available online through MWHC library: 1999- June 2013, Available in print through MWHC library: 1999 - 2006

Background: Unlike virtually all other cancer types, thyroid cancer is unique in that patient age is a key component in its staging. Pathologists and clinicians worldwide have accepted an age cutoff of 45 years for staging; in 2018, this advances to age 55 years in the eighth edition of the American Joint Commission on Cancer staging system. Conclusions: Among all cancers, age has an important role in only thyroid cancer staging. The consideration of age as a continuous variable and the search for age-associated prognostic variables could elucidate a more accurate staging system. Evidence Acquisition: Clinical and basic research studies, reviews, and previous editions of consensus statements regarding thyroid cancer staging were reviewed, with particular focus on the influence of age in thyroid cancer prognosis. Evidence Synthesis: The majority of findings report an association of age with thyroid cancer survival but do not support a specific age cutoff; rather, they suggest that outcome is affected by age as a continuous variable. Conceivably, other factors interact with age on a continuous basis over time, affecting prognosis. When identified, these factors could alter our current concept of the importance of an age cutoff in staging. Purpose: This perspective briefly reviews the basis for this practice and challenges it as no more appropriate than for other malignancies.


English

0021-972X

10.1210/jc.2017-02725 [doi] 4993640 [pii]


*Adenocarcinoma, Follicular/pa [Pathology]
*Aging/ph [Physiology]
*Carcinoma, Papillary/pa [Pathology]
*Neoplasm Staging/st [Standards]
*Thyroid Neoplasms/pa [Pathology]
Age Factors
Diagnostic Techniques, Endocrine/st [Standards]
Humans
Neoplasm Staging/mt [Methods]
Prognosis
Reference Values


MedStar Health Research Institute
MedStar Washington Hospital Center


Medicine/Endocrinology
Medicine/Nuclear Medicine


Journal Article

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