Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Jun 1;22(1):146.
doi: 10.1186/s12902-022-01054-y.

Comparison of the prognostic value of AJCC cancer staging system 7th and 8th editions for differentiated thyroid cancer

Y J Morosán Allo  1 , L Bosio  1 , A Morejón  1 , C Parisi  1 , M C Faingold  1 , V Ilera  2 , A Gauna  2 , G Brenta  3
Affiliations
Case Reports

Comparison of the prognostic value of AJCC cancer staging system 7th and 8th editions for differentiated thyroid cancer

Y J Morosán Allo et al. BMC Endocr Disord. .

Abstract

Background: In the last American Joint Committee on Cancer/Tumor, Node, Metastasis (AJCC/TNM) 8th edition (TNM8), several changes were introduced to this risk stratification system to improve the prognosis of differentiated thyroid cancer (DTC).

Aim: To validate the impact of TNM8 vs. TNM 7th edition (TNM7) in DTC in terms of predictive value in two hospitals from Buenos Aires, Argentina.

Methods: Retrospective study of DTC patients from two institutions. Reclassification from TNM7 to TNM8, disease-specific survival (DSS), and final clinical outcomes at the end of follow-up (recurrent/persistent structural disease) (median 5 years) were analyzed. The proportion of variation explained (PVE) was used to compare the predictive capability of DSS of both classification systems.

Results: Reclassification of 245 patients, aged (mean ± SD) 55 ± 15.36 years, 91% women, to TNM8 from TNM7 showed: 82% vs 57% stage I (SI), 10% vs 8.5% SII, 5% vs 22% SIII, 3% vs 12% SIV (p < 0.01). Forty percent of the population was downstaged with TNM8. Ten-year DSS rates for SI, SII, SIII and SIV in TNM7 were 100, 100, 100 and 74%, respectively and in TNM8: 97.6, 100, 100 and 37.5%, respectively. Out of 4 disease-specific deaths in SIV TNM7, one was subclassified to SI TNM8, corresponding to a 53-year-old patient with structural persistence. PVE for TNM8 (29%) was more than twice that of TNM7 (13%).

Conclusion: In this Argentinian DTC patients sample, it was confirmed that the new TNM8 classification is more accurate in predicting survival attributable to cancer than its previous version.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of DTC patients in each stage of TNM8 and TNM7 after reclassification
Fig. 2
Fig. 2
Comparison of Disease-Specific Mortality in SI-III vs. SIV between TNM7 and TNM8
Fig. 3
Fig. 3
Kaplan Meier cancer-specific survival curves according to the (a) TNM7 and (b) TNM8 staging system
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Tuttle M, Morris LF, Haugen B, Shah J, Sosa JA, Rohren E, et al. Thyroid-differentiated and anaplastic carcinoma (chapter 73) In: Amin MB, Edge SB, Greene F, Byrd D, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, Sullivan DC, Jessup JM, Brierley J, Gaspar LE, Schilsky RL, Balch CM, Winchester DP, Asare EA, Madera M, Gress DM, Meyer LR, et al., editors. AJCC Cancer staging manual. 8. New York City: Springer International Publishing; 2017.
    1. Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, et al. 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–133. doi: 10.1089/thy.2015.0020. - DOI - PMC - PubMed
    1. Van Velsen E, Stegenga MT, van Kemenade FJ, Kam BL, van Ginhoven TM, Visser WE, et al. Comparing the prognostic value of the eighth edition of the AJCC/TNM staging system between papillary and follicular thyroid cancer. Thyroid. 2018;28(8):976–981. doi: 10.1089/thy.2018.0066. - DOI - PubMed
    1. Ito Y, Miyauchi A, Hirokawa M, Yamamoto M, Oda H, Masuoka H, et al. Prognostic value of the 8th edition of the tumor-node -metastasis classification for patients with papillary thyroid carcinoma: a single-institution study at a high volume center in Japan. Endocr J. 2018;65(7):707–716. doi: 10.1507/endocrj.EJ18-0019. - DOI - PubMed
    1. Nixon IJ, Wang L, Migliacci J, Eskander A, Campbell M, Aniss A, et al. An international multi-institutional validation of age 55 years as a cut-off for risk stratification in the AJCC/UICC staging system for well differentiated thyroid Cancer. Thyroid. 2016;26(3):373–380. doi: 10.1089/thy.2015.0315. - DOI - PMC - PubMed

Publication types