Impact of the change from the seventh to eighth edition of the AJCC TNM classification of malignant tumours and comparison with the MACIS prognostic scoring system in non-medullary thyroid cancer.
Journal
BJS open
ISSN: 2474-9842
Titre abrégé: BJS Open
Pays: England
ID NLM: 101722685
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
received:
23
10
2018
accepted:
11
04
2019
entrez:
9
10
2019
pubmed:
9
10
2019
medline:
9
10
2019
Statut:
epublish
Résumé
In 2018, AJCC TNM staging changed for differentiated (DTC) and anaplastic (ATC) thyroid carcinoma. The impact of this change on mortality rates was investigated and compared with the MACIS prognostic score. Analysis of a prospective database of DTC/ATC was undertaken. Patients were staged according to TNM7 and TNM8 criteria, and MACIS scores calculated. Five-year disease-specific mortality rates were determined. Proportions were compared with Fisher's exact and χ Between August 2002 and December 2016, 310 patients had primary surgery for thyroid cancer. After exclusions, 159 patients (154 DTC, 5 ATC) remained to be studied. The MACIS score was less than 6 in 105 patients (66·0 per cent), 6-6·99 in 19 (11·9 per cent), 7-7·99 in 14 (8·8 per cent) and 8 or more in 21 (13·2 per cent), with corresponding disease-specific 5-year mortality rates of 0, 5, 14 and 86 per cent. For TNM7 the distribution was stage I in 53·5 per cent (85 patients), stage II in 10·1 per cent (16), stage III in 14·5 per cent (23) and stage IV in 22·0 per cent (35), and differed from that for TNM8: 76·7 per cent (122), 10·7 per cent (17), 4·4 per cent (7) and 8·2 per cent (13) respectively ( Compared with TNM7, TNM8 downstaged more patients to stage I and accurately reflected worse prognosis for stage IV disease. TNM8 is an inferior predictor of mortality compared with MACIS.
Sections du résumé
Background
In 2018, AJCC TNM staging changed for differentiated (DTC) and anaplastic (ATC) thyroid carcinoma. The impact of this change on mortality rates was investigated and compared with the MACIS prognostic score.
Methods
Analysis of a prospective database of DTC/ATC was undertaken. Patients were staged according to TNM7 and TNM8 criteria, and MACIS scores calculated. Five-year disease-specific mortality rates were determined. Proportions were compared with Fisher's exact and χ
Results
Between August 2002 and December 2016, 310 patients had primary surgery for thyroid cancer. After exclusions, 159 patients (154 DTC, 5 ATC) remained to be studied. The MACIS score was less than 6 in 105 patients (66·0 per cent), 6-6·99 in 19 (11·9 per cent), 7-7·99 in 14 (8·8 per cent) and 8 or more in 21 (13·2 per cent), with corresponding disease-specific 5-year mortality rates of 0, 5, 14 and 86 per cent. For TNM7 the distribution was stage I in 53·5 per cent (85 patients), stage II in 10·1 per cent (16), stage III in 14·5 per cent (23) and stage IV in 22·0 per cent (35), and differed from that for TNM8: 76·7 per cent (122), 10·7 per cent (17), 4·4 per cent (7) and 8·2 per cent (13) respectively (
Conclusion
Compared with TNM7, TNM8 downstaged more patients to stage I and accurately reflected worse prognosis for stage IV disease. TNM8 is an inferior predictor of mortality compared with MACIS.
Identifiants
pubmed: 31592514
doi: 10.1002/bjs5.50182
pii: BJS550182
pmc: PMC6773661
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Pagination
623-628Informations de copyright
© 2019 The Authors. BJS Open published by John Wiley & Sons Ltd on behalf of BJS Society Ltd.
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