Projecting Survival in Papillary Thyroid Cancer: A Comparison of the 7th and 8th Editions of the AJCC/UICC Staging Systems in Two Contemporary National Patient Cohorts.
Thyroid. 2017 Sep 11;:
Authors: Pontius LN, Oyekunle TO, Thomas S, Stang M, Scheri RP, Roman S, Sosa JA
Abstract
BACKGROUND: This study aims to compare the 7th and 8th editions of the AJCC/UICC TNM staging system for patients with papillary thyroid cancer (PTC) in two national patient cohorts.
METHODS: Adult PTC patients undergoing surgery were selected from SEER (2004-2012) and NCDB (2004-2012). Staging criteria for the 7th and 8th AJCC/UICC editions were applied separately to both cohorts; survival probabilities were estimated using the Kaplan-Meier method. Multivariable Cox proportional hazards models were used to estimate the association of stage with survival in both settings. The Akaike information criterion (AIC) was used to assess model performance.
RESULTS: About 23% of patients were down-staged from the 7th to the 8th edition in SEER, while 24% were down-staged in NCDB. DSS and OS were significantly related to stage at diagnosis when using both the 7th and 8th editions of the AJCC/UICC staging system (p<0.001). Patients classified into higher stages (III and IV) in the 8th edition showed a worse prognosis than those classified into similar stages in the 7th edition. After adjustment, PTC stages as defined by both editions were significantly associated with DSS and OS. With respect to both DSS and OS, the 8th edition PTC model appeared to be a better fit to the data (smaller AIC values) compared to the 7th edition.
CONCLUSION: Based on these large contemporary national cohorts, the 8th edition AJCC/UICC TNM classification for PTC is superior to the 7th edition for predicting survival.
PMID: 28891405 [PubMed - as supplied by publisher]
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