Vrachimis Alexis, Gerss Joachim, Stoyke Maren, Wittekind Christian, Maier Tobias, Wenning Christian, Rahbar Kambiz, Schober Otmar, Riemann Burkhard
Department of Nuclear Medicine, University Hospital Münster, Münster, Germany.
Clin Endocrinol (Oxf). 2014 Jun;80(6):911-7. doi: 10.1111/cen.12405. Epub 2014 Feb 4.
The seventh edition of the American Joint Committee on Cancer (AJCC) has more detailed staging categories for differentiated thyroid cancer (DTC) than the fifth edition. The aim was to compare potential alterations in the disease-specific (DSS), event-free (EFS) and overall survival (OS), after reclassification from the fifth to the seventh edition.
Data of 2460 patients with DTC referred to our centre were reclassified from the fifth to the seventh edition of AJCC. DSS, EFS and OS were calculated using the Kaplan-Meier method and compared by the log-rank test. The relative abilities of each edition to predict survival were calculated by the proportion of variance explained (PVE).
After reclassification to the seventh edition, there was an increase in stage I and IV patients from 58·1% to 65·0% and from 6·2% to 10·1%, respectively, and a corresponding decrease in stage II and III patients from 22·4% to 12·5% and 13·3% to 12·4%, respectively. As to DSS, the seventh edition had only a marginally higher PVE value than the fifth edition. With respect to EFS, the predictability of the seventh edition was even inferior to that of the fifth edition. Similarly, with regard to OS, the PVE value was slightly better for the older edition. Furthermore, a comparison only for those patients affected by the reclassification revealed no differences for DSS, EFS or OS between classifications.
When comparing the stages of the seventh with the fifth edition of the AJCC for DTC, there was no significant difference in predicting DSS, EFS and OS.
美国癌症联合委员会（AJCC）第七版对分化型甲状腺癌（DTC）的分期类别比第五版更详细。目的是比较从第五版重新分类到第七版后疾病特异性生存（DSS）、无事件生存（EFS）和总生存（OS）的潜在变化。
将转诊至我们中心的2460例DTC患者的数据从AJCC第五版重新分类到第七版。采用Kaplan-Meier法计算DSS、EFS和OS，并通过对数秩检验进行比较。通过解释方差比例（PVE）计算各版预测生存的相对能力。
重新分类到第七版后，I期和IV期患者分别从58.1%增至65.0%和从6.2%增至10.1%，相应地，II期和III期患者分别从22.4%降至12.5%和从13.3%降至12.4%。关于DSS，第七版的PVE值仅略高于第五版。关于EFS，第七版的预测性甚至不如第五版。同样，关于OS，旧版的PVE值略好。此外，仅对受重新分类影响的患者进行比较，各分类之间在DSS、EFS或OS方面无差异。
比较AJCC第七版和第五版DTC分期时，在预测DSS、EFS和OS方面无显著差异。
