Sherman S I, Brierley J D, Sperling M, Ain K B, Bigos S T, Cooper D S, Haugen B R, Ho M, Klein I, Ladenson P W, Robbins J, Ross D S, Specker B, Taylor T, Maxon H R
Section of Endocrine Neoplasia and Hormonal Disorders, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA.
Cancer. 1998 Sep 1;83(5):1012-21. doi: 10.1002/(sici)1097-0142(19980901)83:5<1012::aid-cncr28>3.0.co;2-9.
A novel prognostic staging classification encompassing all forms of thyroid carcinoma was created for the National Thyroid Cancer Treatment Cooperative Study (NTCTCS) Registry, with the goal of prospective validation and comparison with other available staging classifications.
Patient information was recorded prospectively from 14 institutions. Clinicopathologic staging was based on patient age at diagnosis, tumor histology, tumor size, intrathyroidal multifocality, extraglandular invasion, metastases, and tumor differentiation.
Between 1987 and 1995, 1607 patients were registered. Approximately 43% of patients were classified as NTCTCS Stage I, 24% Stage II, 24% Stage III, and 9% Stage IV. Patients with follicular carcinoma were more likely to have "high risk" Stage III or IV disease than those with papillary carcinoma. Of 1562 patients for whom censored follow-up was available (median follow-up, 40 months), 78 died of thyroid carcinoma or complications of its treatment. Five-year product-limit patient disease specific survival was 99.8% for Stage I, 100% for Stage II, 91.9% for Stage III, and 48.9% for Stage IV (P < 0.0001). The frequency of remaining disease free also declined significantly with increasing stage (94.3% for Stage I, 93.1%for Stage II, 77.8% for Stage III, and 24.6% for Stage IV). The same patients also were staged applying six previously published classifications as appropriate for their tumor type. The predictive value of the NTCTCS Registry staging classification consistently was among the highest for disease specific mortality and for remaining disease free, regardless of the tumor type.
The NTCTCS Registry staging classification provides a prospectively validated scheme for predicting short term prognosis for patients with thyroid carcinoma.
为国家甲状腺癌治疗合作研究（NTCTCS）登记处创建了一种涵盖所有甲状腺癌形式的新型预后分期分类法，目的是进行前瞻性验证并与其他现有分期分类法进行比较。
前瞻性记录了来自14个机构的患者信息。临床病理分期基于诊断时的患者年龄、肿瘤组织学、肿瘤大小、甲状腺内多灶性、腺外侵犯、转移情况以及肿瘤分化程度。
1987年至1995年间，登记了1607例患者。约43%的患者被分类为NTCTCS I期，24%为II期，24%为III期，9%为IV期。滤泡癌患者比乳头状癌患者更有可能患有“高危”III期或IV期疾病。在1562例有截尾随访数据的患者中（中位随访时间为40个月），78例死于甲状腺癌或其治疗并发症。I期患者的五年乘积限法患者疾病特异性生存率为99.8%，II期为100%，III期为91.9%，IV期为48.9%（P<0.0001）。随着分期增加，无疾病残留的频率也显著下降（I期为94.3%，II期为93.1%，III期为77.8%，IV期为24.6%）。对同一批患者，还根据其肿瘤类型采用六种先前发表的分类法进行了分期。无论肿瘤类型如何，NTCTCS登记处分期分类法对疾病特异性死亡率和无疾病残留的预测价值始终是最高的之一。
NTCTCS登记处分期分类法为预测甲状腺癌患者的短期预后提供了一种经过前瞻性验证的方案。
