Differentiated thyroid cancer: Clinicopathologic staging
- R Michael Tuttle, MD
R Michael Tuttle, MD
- Professor of Medicine
- Memorial Sloan Kettering Cancer Center
Clinicopathologic staging of patients with cancer is valuable for many reasons, including the following:
●To estimate risk of recurrence and disease-specific mortality for an individual patient
●To tailor decisions regarding postoperative adjunctive therapy (such as the need for radioiodine ablation and degree of thyroid-stimulating hormone [TSH] suppression) to the patient's risk for disease recurrence and mortality
●To make decisions regarding the frequency, modality, and intensity of follow-up based upon an individual patient's risk of recurrence and mortality
●To enable accurate communication regarding a patient among health care professionals
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- STAGING FOR DIFFERENTIATED THYROID CANCER
- Staging systems for predicting disease-specific mortality
- - TNM system
- - MACIS system
- - National Thyroid Cancer Treatment Cooperative Study
- Staging systems used to predict initial risk of recurrence
- - ATA risk stratification
- Dynamic risk stratification
- OTHER PROGNOSTIC FACTORS
- Lymphocytic infiltration
- PET-positive tumors
- Histologic subtypes
- Molecular characteristics
- SUMMARY AND RECOMMENDATIONS