Annals of Surgical Oncology Sign the Guestbook
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
10.1245/s10434-006-9242-2
Annals of Surgical Oncology 14:1551-1559 (2007)
© 2007 Society of Surgical Oncology
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lang, B.
Right arrow Articles by Wan, K.-Y.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lang, B.
Right arrow Articles by Wan, K.-Y.

Original Article

Restaging of Differentiated Thyroid Carcinoma by the Sixth Edition AJCC/UICC TNM Staging System: Stage Migration and Predictability

Brian Lang, MS, FRACS1, Chung-Yau Lo, MS, FRCS (Edin), FACS1, Wai-Fan Chan, MBBS, FRCS1, King-Yin Lam, MD, FRCPA2 and Koon-Yat Wan, MBBS, FRCR3

1 Division of Endocrine Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China
2 Discipline of Pathology, School of Medicine, Griffith University, Gold Coast, Australia
3 Department of Clinical Oncology, University of Hong Kong Medical Centre, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong SAR, China

Correspondence: Address correspondence and reprint requests to: Chung-Yau Lo, MS, FRCS (Edin), FACS; E-mail: cylo{at}hkucc.hku.hk

Background: The AJCC/UICC TNM staging system (TNM) is a widely accepted system for differentiated thyroid carcinoma (DTC). The objective of the present study was to evaluate the potential changes in cancer-specific survival (CSS) after reclassification from fifth to sixth edition TNM.

Methods: A total of 760 DTC patients managed at our institution from 1961 to 2001 were retrospectively restaged from the fifth to sixth edition TNM. CSS were calculated using Kaplan–Meier method and were compared by the log-rank test. The relative ability of each edition in predicting CSS was calculated by the proportion of variance explained (PVE).

Results: Upon reclassification, the proportion of T1 and T3 tumors increased from 14.2 to 33.4% and 10.0 to 33.7%; T2 and T4 decreased from 44.2 to 25.0% and 31.6 to 7.9%, respectively; N0 remained unchanged at 66.0%; N1a decreased from 25.7 to 4.7%; N1b increased from 8.4 to 29.3%; stages I and IV tumors increased from 55.7 to 60.3% and 3.4 to 17.6%, respectively; stages II and III tumors decreased from 20.5 to 13.9% and 20.4 to 8.2%, respectively. The sixth edition had a higher PVE value than the fifth edition. Significant differences in CSS were observed between stage III (fifth edition) and stage III (sixth edition) and between stage IV (fifth edition) and stage IVA (sixth edition).

Conclusions: The sixth edition TNM caused marked changes in the pT, pN and allocation of patients into different tumor stages. It appeared to have superior predictability over the fifth edition.

Key Words: TNM • Differentiated thyroid carcinoma • Papillary thyroid carcinoma • Follicular thyroid carcinoma • Staging • Risk stratification




This article has been cited by other articles:


Home page
 Ann. Surg. Oncol.Home page
N. Wada, K. Masudo, H. Nakayama, N. Suganuma, K. Matsuzu, S. Hirakawa, Y. Rino, M. Masuda, and T. Imada
Recommendation for Subclass Evaluation of TNM stage IVA Papillary Thyroid Carcinomas: T4aN1b Patients Are at Risk for Recurrence and Survival
Ann. Surg. Oncol., May 1, 2008; 15(5): 1511 - 1517.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2007 by the Society of Surgical Oncology.