美国癌症联合委员会（AJCC）第8版肿瘤、淋巴结、转移（TNM）分期系统对泰国分化型甲状腺癌患者预后的影响。

Impacts of the American Joint Committee on Cancer (AJCC) 8 edition tumor, node, metastasis (TNM) staging system on outcomes of differentiated thyroid cancer in Thai patients.

作者信息

Thewjitcharoen Yotsapon, Chatchomchuan Waralee, Karndumri Krittadhee, Porramatikul Sriurai, Krittiyawong Sirinate, Wanothayaroj Ekgaluck, Butadej Siriwan, Nakasatien Soontaree, Veerasomboonsin Veekij, Kanchanapituk Auchai, Rajatanavin Rajata, Himathongkam Thep

机构信息

Diabetes and Thyroid Center, Theptarin Hospital, Bangkok, Thailand.

Division of Radiology, Theptarin Hospital, Bangkok, Thailand.

出版信息

Heliyon. 2021 Mar 30;7(3):e06624. doi: 10.1016/j.heliyon.2021.e06624. eCollection 2021 Mar.

BACKGROUND

In 2018, the American Joint Committee on Cancer (AJCC) 8 edition (AJCC8) was introduced to replace the previous version (AJCC7) due to superiority of AJCC8 over AJCC7 for better prediction of survival from thyroid cancer.

AIM

To compare AJCC staging systems with the American Thyroid Association (ATA) risk classification for the prediction of 5-year disease-free survival (DFS), and 5-year disease-specific survival (DSS) in Thai patients.

METHODS

We retrospectively reviewed all patients with histopathologic diagnosis of DTC who were treated at Theptarin Hospital, Bangkok, Thailand from 1987 to 2019.

RESULTS

The study cohort included 262 differentiated thyroid cancer (DTC) patients (papillary thyroid cancer 89.7% with a median time of follow-up 7.8 years). The number (%) of patients within each stage group by AJCC7 and AJCC8 respectively are as follows: Stage I: 173 (66.0%) vs. 232 (88.5%), Stage II: 33 (12.6%) vs. 24 (9.2%), Stage III: 36 (13.7%) vs. 2 (0.8%), Stage IV: 20 (7.7%) vs. 4 (1.5%). The ATA high risk group was found in 24.3% of AJCC7 Stage I compared with 23.7% of AJCC8 Stage I. The 5-year DFS rates in patients classified as stages I, II, III, and IV by AJCC8 were 87.9%, 45.8%, 0% and 25%, respectively. The 5-year DSS rates in patients classified as stages I, II, III and IV by AJCC8 were 98.7%, 100%, 100% and 0%, respectively. AJCC8 was more predictive of DFS rate than AJCC7.

CONCLUSIONS

Our study is in accord with previous studies that AJCC8 downstage a significant percentage of patients with DTC and correlated with better prognostic validity. However, even a person at low risk for mortality can be at high risk for recurrence.

背景

2018年，美国癌症联合委员会（AJCC）第8版（AJCC8）被引入以取代先前版本（AJCC7），因为AJCC8在更好地预测甲状腺癌生存率方面优于AJCC7。

目的

比较AJCC分期系统与美国甲状腺协会（ATA）风险分类对泰国患者5年无病生存率（DFS）和5年疾病特异性生存率（DSS）的预测情况。

方法

我们回顾性分析了1987年至2019年在泰国曼谷Theptarin医院接受治疗的所有经组织病理学诊断为分化型甲状腺癌（DTC）的患者。

结果

研究队列包括262例分化型甲状腺癌（DTC）患者（乳头状甲状腺癌占89.7%，中位随访时间为7.8年）。AJCC7和AJCC8各分期组患者的数量（%）分别如下：I期：173例（66.0%）对232例（88.5%），II期：33例（12.6%）对24例（9.2%），III期：36例（13.7%）对2例（0.8%），IV期：20例（7.7%）对4例（1.5%）。AJCC7 I期患者中24.3%属于ATA高风险组，而AJCC8 I期患者中这一比例为23.7%。AJCC8将患者分为I、II、III和IV期，其5年DFS率分别为87.9%、45.8%、0%和25%。AJCC8将患者分为I、II、III和IV期，其5年DSS率分别为98.7%、100%、100%和0%。AJCC8对DFS率的预测比AJCC7更准确。