Comparison of the 7th and 8th Editions of the AJCC/UICC TNM Staging System for Differentiated Thyroid Cancer.

Comparison of the 7th and 8th Editions of the AJCC/UICC TNM Staging System for Differentiated Thyroid Cancer.

Thyroid. 2017 Jun 21;:

Authors: Kim M, Kim WG, Oh HS, Park S, Kwon H, Song DE, Kim TY, Shong Y, Kim WB, Sung TY, Jeon M

Abstract
OBJECTIVE: To evaluate the efficacy and prognostic validity for disease-specific survival (DSS) of the 8th edition American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) tumor-node-metastasis (TNM) staging system (TNM-8) compared with the 7th edition (TNM-7) in patients with differentiated thyroid carcinoma (DTC).
METHODS: The 7th and 8th editions of the TNM staging system were applied to 1613 DTC patients who underwent thyroid surgery between 1996 and 2003. We evaluated the proportion of variation explained (PVE) and Harrell's c-index to compare the predictive capability of DSS.
RESULTS: Mean age of the patients was 44.7 years and the median follow-up period was 11.2 years. When we applied TNM-8, 30% of T3 and 3% of N1b DTCs were down-graded to T1/T2 and N1a, respectively. About 38% of patients were down-staged according to TNM-8. The 10-year DSS rates in TNM-7 stage I, II, III, and IV were 99.7, 98.2, 98.8 and 83.2%, respectively. Those in TNM-8 stage I, II, III, and IV were 99.6, 95.4, 72.3 and 48.6%, respectively. The PVE values of TNM-7 and TNM-8 were 6.0% and 7.0%, respectively. The Harrell's c-index of TNM-7 was 0.86 and that of TNM-8 was 0.88.
CONCLUSIONS: A significant number of patients were re-classified to lower stages with the application of TNM-8 compared to TNM-7. Applying TNM-8 could improve the accuracy of the staging system for predicting DSS in patients with DTC.

PMID: 28635571 [PubMed - as supplied by publisher]

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