Endocrine Abstracts

Aim: The aim of the present study was to compare version 7 of ATA risk calculating tool, developed for the staging of well differentiated thyroid cancers,and is used commonly in the clinical practice with its version 8 developed in 2018 with respect to clinical staging.

Material and method: 295 patients followed with the diagnosis of well differentiated thyroid cancer were included in the present study. According to pathology reports and clinical data, their stages were calculated using risk calculator tool AJCC(AmericanJointCommittee on Cancer) of ATA Version 7(Ver7) and Version8(Ver8). Age, sex, age of diagnosis, duration of disease, pathology reports, the presence of metastasis and radioactive iodine ablation (RAI) were evaluated retrospectively.

Results: Of 295 cases included in the study, (F/M:242/53) 191 was classified as Stage 1, 9 as Stage 2, 83 as Stage 3, and 12 as Stage 4 by Ver7. When the same patients were evaluated with Ver8, 268 was classified as Stage 1, 26 as Stage 2, 1 as Stage 4, without any patients in Stage 3.All patients classified as Stage 1 in Ver7 remained in Stage 1 with Ver8. It was also established that higher number of Stage 1 patients were classified as high risk in Ver8 and that MACIS and AMES scores did not change for the same patient between Ver7 and Ver8 and AGES value was not given in Ver8. However, it was also found that of 83 patients classified as Stage 3 in Ver7, 68 were classified as Stage 1 and 15 as Stage 2 in Ver8. In addition, of 12 patients classified as Stage 4 in Ver7, 6 were classified as Stage 1, 5 as Stage 2 and 1 as Stage 4 in Ver8. Of patients classified as Stage 1 both in Ver7 and Ver8, age, age of diagnosis, and MACIS values were found to be signficantly higher in the latter version. There was significant difference between patients who were classified as Stage 3 in Ver7 and as Stage 1 and 2 in Ver8 in terms of the age of diagnosis, maximum tumor size and MACIS values.

Conclusion: ATA staging calculator Ver8 classifies the patients into lower stages but to higher risk groups compared to previous version. It is thought that multicentricity and invasion criteria in addition to new age and tumor size limit may have been influential in this result.