分化型甲状腺癌的生存：第 7 版和第 8 版 AJCC/UICC TNM 分期系统与 ATA 初始风险分层系统的比较。
Survival in differentiated thyroid carcinoma: Comparison between the 7th and 8th editions of the AJCC/UICC TNM staging system and the ATA initial risk stratification system.
机构信息
Department of Head and Neck Surgery, University of Sao Paulo Medical School, São Paulo, Brazil.
Head and Neck Surgery Service, Sao Paulo State Cancer Institute, Sao Paulo, Brazil.
出版信息
Head Neck. 2021 Oct;43(10):2913-2922. doi: 10.1002/hed.26773. Epub 2021 Jun 1.
BACKGROUND
The AJCC/UICC TNM staging system evaluates the risk of death from cancer. Its 8th edition aimed to increase its accuracy. In turn, the American Thyroid Association proposed an initial risk stratification system (IRSS) focusing on the risk of recurrence in differentiated thyroid carcinoma. The present study intended to analyze their prediction abilities.
METHODS
Six hundred and eighty-five consecutive surgical patients (mean follow-up 71.6 months) were staged. Correlations with disease-free survival (DFS) and overall survival (OS) were carried out.
RESULTS
IRSS was discriminative for DFS but not for OS. Applying TNM 8th, 36.9% of the cohort was downstaged. Their DFS was shorter, compared with other patients in the same stage, but with no impact on OS. However, all those who died of the disease had been downstaged.
CONCLUSIONS
IRSS was more effective to predict DFS, but not OS. TNM 8th was more appropriate for OS analysis than TNM 7th and IRSS.
背景
AJCC/UICC TNM 分期系统评估癌症死亡风险。其第 8 版旨在提高其准确性。美国甲状腺协会随后提出了一个侧重于分化型甲状腺癌复发风险的初始风险分层系统（IRSS）。本研究旨在分析其预测能力。
方法
对 685 例连续手术患者（平均随访 71.6 个月）进行分期。分析与无病生存（DFS）和总生存（OS）的相关性。
结果
IRSS 对 DFS 具有区分能力，但对 OS 没有区分能力。应用第 8 版 AJCC/UICC TNM 分期系统，685 例患者中 36.9%降期。与同一分期的其他患者相比，他们的 DFS 更短，但对 OS 没有影响。然而，所有死于该疾病的患者都降期了。
结论
IRSS 更有效地预测 DFS，但不能预测 OS。与第 7 版 TNM 和 IRSS 相比，第 8 版 AJCC/UICC TNM 更适合 OS 分析。
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