Background:

The 8th edition of the American Joint Committee on Cancer/Union for International Cancer Control (AJCC/UICC) tumor-node-metastasis (TNM) staging system was released with major revisions. The purpose of this retrospective study was to investigate differences between the 7th and 8th editions of the AJCC/UICC TNM staging system and to compare the predictability of prognosis between the two staging systems with patients who underwent thyroidectomy for differentiated thyroid cancer (DTC) at a single institution.

Methods:

A total of 3238 patients underwent thyroid operation from January 2002 to December 2006 at Yonsei University Hospital (Seoul, Korea), of which 2294 with complete clinical data and sustained follow up were enrolled. Clinicopathologic features and TNM staging by applying the 7th and 8th editions of the AJCC/UICC were analyzed retrospectively by the complete review of medical charts and pathology reports of patients. Mean follow-up duration was 132.9 ± 27.9 months.

Results:

A significant number of T3 patients were downstaged to T1 (838, 36.5%) and T2 (122, 5.3%). After applying the 8th edition of the AJCC/UICC TNM staging system, the number of stage I patients increased significantly from 1434 (62.5%) to 2058 (89.7%), whereas numbers of stage III and IV patients decreased significantly from 644 (28.1%) to 33 (1.4%) and from 199 (8.7%) to 17 (0.7%), respectively. According to Kaplan–Meier survival analyses and values of the Harrell’s c-index and integrated area under the curve (iAUC), the 8th edition has significantly better predictive performance for disease-free survival (DFS) and disease-specific survival (DSS) than the 7th edition.

Conclusions:

A significant population was downstaged after applying the 8th edition of the AJCC/UICC TNM staging system, and the 8th edition provided significantly better accuracy in predicting DFS and DSS in patients with DTC.

中文翻译：

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根据第 7 版和第 8 版 AJCC/UICC TNM 分期系统对分化型甲状腺癌的长期预后进行比较。

 背景：

美国癌症联合委员会/国际癌症控制联盟（AJCC/UICC）肿瘤-淋巴结-转移（TNM）分期系统第8版发布，并进行了重大修订。这项回顾性研究的目的是调查第 7 版和第 8 版 AJCC/UICC TNM 分期系统之间的差异，并比较两个分期系统对因分化型甲状腺癌 (DTC) 接受甲状腺切除术的患者的预后的预测能力。单一机构。

 方法：

2002年1月至2006年12月在延世大学医院（韩国首尔）共有3238名患者接受了甲状腺手术，其中2294名具有完整临床资料和持续随访的患者入组。通过完整回顾患者的病历和病理报告，对应用第7版和第8版AJCC/UICC的临床病理特征和TNM分期进行回顾性分析。平均随访时间为 132.9 ± 27.9 个月。

 结果：

大量 T3 患者降级至 T1（838 例，36.5%）和 T2（122 例，5.3%）。应用第8版AJCC/UICC TNM分期系统后，I期患者数量从1434例（62.5%）显着增加至2058例（89.7%），而III期和IV期患者数量从644例（28.1%）显着减少。 ）分别从 33 个（1.4%）和 199 个（8.7%）增加到 17 个（0.7%）。根据 Kaplan-Meier 生存分析以及 Harrell's c 指数和积分曲线下面积 (iAUC) 值，第 8 版在无病生存 (DFS) 和疾病特异性生存 (DSS) 方面的预测性能明显优于第七版。

 结论：

应用第 8 版 AJCC/UICC TNM 分期系统后，大量人群被降级，并且第 8 版在预测 DTC 患者的 DFS 和 DSS 方面提供了显着更高的准确性。