Skip to main content
Erschienen in: Annals of Surgical Oncology 9/2019

04.03.2019 | Endocrine Tumors

Risk of Recurrence in Differentiated Thyroid Cancer: A Population-Based Comparison of the 7th and 8th Editions of the American Joint Committee on Cancer Staging Systems

verfasst von: Tong Gan, MD, Bin Huang, DrPH, Quan Chen, DrPH, Heather F. Sinner, MD, Cortney Y. Lee, MD, FACS, David A. Sloan, MD, FACS, FRCSC, Reese W. Randle, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 9/2019

Einloggen, um Zugang zu erhalten

Abstract

Background

Differentiated thyroid cancer (DTC) survival is excellent, making recurrence a more clinically relevant prognosticator. We hypothesized that the new American Joint Committee on Cancer (AJCC) 8th edition improves on the utility of the 7th edition in predicting the risk of recurrence in DTC.

Methods

A population-based retrospective review compared the risk of recurrence in patients with DTC according to the AJCC 7th and 8th editions using the Surveillance, Epidemiology, and End Results-based Kentucky Cancer Registry from 2004 to 2012.

Results

A total of 3248 patients with DTC were considered disease-free after treatment. Twenty percent of patients were downstaged from the 7th edition to the 8th edition. Most patients had stage I disease (80% in the 7th edition and 94% in the 8th edition). A total of 110 (3%) patients recurred after a median of 27 months. The risk of recurrence was significantly associated with stage for both editions (p < 0.001). In the 7th edition, there was poor differentiation between lower stages and better differentiation between higher stages (stage II hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.39–2.11; stage III HR 3.72, 95% CI 2.29–6.07; stage IV HR 11.66, 95% CI 7.10–19.15; all compared with stage I). The 8th edition better differentiated lower stages (stage II HR 4.06, 95% CI 2.38–6.93; stage III HR 13.07, 95% CI 5.30–32.22; stage IV 11.88, 95% CI 3.76–37.59; all compared with stage I).

Conclusions

The AJCC 8th edition better differentiates the risk of DTC recurrence for early stages of disease compared with the 7th edition. However, limitations remain, emphasizing the importance of adjunctive strategies to estimate the risk of recurrence.
Literatur
2.
Zurück zum Zitat Haugen BR, Alexander EK, Bible KC, et al. American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–33.CrossRefPubMedPubMedCentral Haugen BR, Alexander EK, Bible KC, et al. American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association Guidelines Task Force on thyroid nodules and differentiated thyroid cancer. Thyroid. 2016;26(1):1–33.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Ge MH, Cao J, Wang JY, et al. Nomograms predicting disease-specific regional recurrence and distant recurrence of papillary thyroid carcinoma following partial or total thyroidectomy. Medicine (Baltimore). 2017;96(30):e7575.CrossRef Ge MH, Cao J, Wang JY, et al. Nomograms predicting disease-specific regional recurrence and distant recurrence of papillary thyroid carcinoma following partial or total thyroidectomy. Medicine (Baltimore). 2017;96(30):e7575.CrossRef
4.
Zurück zum Zitat Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.CrossRefPubMed Cooper DS, Doherty GM, Haugen BR, et al. Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. Thyroid. 2009;19(11):1167–214.CrossRefPubMed
5.
Zurück zum Zitat Tuttle RM, Tala H, Shah J, et al. Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system. Thyroid. 2010;20(12):1341–9.CrossRefPubMedPubMedCentral Tuttle RM, Tala H, Shah J, et al. Estimating risk of recurrence in differentiated thyroid cancer after total thyroidectomy and radioactive iodine remnant ablation: using response to therapy variables to modify the initial risk estimates predicted by the new American Thyroid Association staging system. Thyroid. 2010;20(12):1341–9.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Pontius LN, Oyekunle TO, Thomas SM, Stang MT, Scheri RP, Roman SA, Sosa JA. Projecting survival in papillary thyroid cancer: a comparison of the seventh and eighth editions of the American Joint Commission on Cancer/Union for International Cancer Control Staging Systems in Two Contemporary National Patient Cohorts. Thyroid. 2017;27(11):1408–16.CrossRefPubMedPubMedCentral Pontius LN, Oyekunle TO, Thomas SM, Stang MT, Scheri RP, Roman SA, Sosa JA. Projecting survival in papillary thyroid cancer: a comparison of the seventh and eighth editions of the American Joint Commission on Cancer/Union for International Cancer Control Staging Systems in Two Contemporary National Patient Cohorts. Thyroid. 2017;27(11):1408–16.CrossRefPubMedPubMedCentral
7.
Zurück zum Zitat Perrier ND, Brierley JD, Tuttle RM. Differentiated and anaplastic thyroid carcinoma: major changes in the American Joint Committee on Cancer Eighth Edition cancer staging manual. CA Cancer J Clin. 2018;68(1):55–63.CrossRefPubMed Perrier ND, Brierley JD, Tuttle RM. Differentiated and anaplastic thyroid carcinoma: major changes in the American Joint Committee on Cancer Eighth Edition cancer staging manual. CA Cancer J Clin. 2018;68(1):55–63.CrossRefPubMed
8.
Zurück zum Zitat Suh S, Kim YH, Goh TS, et al. Outcome prediction with the revised American joint committee on cancer staging system and American thyroid association guidelines for thyroid cancer. Endocrine. 2017;58(3):495–502.CrossRefPubMed Suh S, Kim YH, Goh TS, et al. Outcome prediction with the revised American joint committee on cancer staging system and American thyroid association guidelines for thyroid cancer. Endocrine. 2017;58(3):495–502.CrossRefPubMed
9.
Zurück zum Zitat van Velsen EFS, Stegenga MT, van Kemenade FJ, Kam BLR, van Ginhoven TM, Visser WE, et al. Comparing the prognostic value of the eighth edition of the American Joint Committee on Cancer/Tumor Node Metastasis Staging System Between Papillary and Follicular Thyroid Cancer. Thyroid. 2018;28(8):976–81.CrossRefPubMed van Velsen EFS, Stegenga MT, van Kemenade FJ, Kam BLR, van Ginhoven TM, Visser WE, et al. Comparing the prognostic value of the eighth edition of the American Joint Committee on Cancer/Tumor Node Metastasis Staging System Between Papillary and Follicular Thyroid Cancer. Thyroid. 2018;28(8):976–81.CrossRefPubMed
10.
Zurück zum Zitat Tuttle RM, Haugen B, Perrier ND. Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for Differentiated and Anaplastic Thyroid Cancer (eighth edition): what changed and why? Thyroid. 2017;27(6):751–6.CrossRefPubMedPubMedCentral Tuttle RM, Haugen B, Perrier ND. Updated American Joint Committee on Cancer/Tumor-Node-Metastasis Staging System for Differentiated and Anaplastic Thyroid Cancer (eighth edition): what changed and why? Thyroid. 2017;27(6):751–6.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Cho JS, Yoon JH, Park MH, Shin SH, Jegal YJ, Lee JS, Kim HK. Age and prognosis of papillary thyroid carcinoma: retrospective stratification into three groups. J Korean Surg Soc. 2012;83(5):259–66.CrossRefPubMedPubMedCentral Cho JS, Yoon JH, Park MH, Shin SH, Jegal YJ, Lee JS, Kim HK. Age and prognosis of papillary thyroid carcinoma: retrospective stratification into three groups. J Korean Surg Soc. 2012;83(5):259–66.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Nixon IJ, Wang LY, Migliacci JC, et al. An International Multi-Institutional Validation of Age 55 Years as a Cutoff for Risk Stratification in the AJCC/UICC Staging System for Well-Differentiated Thyroid Cancer. Thyroid. 2016;26(3):373–80.CrossRefPubMedPubMedCentral Nixon IJ, Wang LY, Migliacci JC, et al. An International Multi-Institutional Validation of Age 55 Years as a Cutoff for Risk Stratification in the AJCC/UICC Staging System for Well-Differentiated Thyroid Cancer. Thyroid. 2016;26(3):373–80.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Buffet C, Golmard JL, Hoang C, et al. Scoring system for predicting recurrences in patients with papillary thyroid microcarcinoma. Eur J Endocrinol. 2012;167(2):267–75.CrossRefPubMed Buffet C, Golmard JL, Hoang C, et al. Scoring system for predicting recurrences in patients with papillary thyroid microcarcinoma. Eur J Endocrinol. 2012;167(2):267–75.CrossRefPubMed
14.
Zurück zum Zitat Kim HJ, Sohn SY, Jang HW, Kim SW, Chung JH. Multifocality, but not bilaterality, is a predictor of disease recurrence/persistence of papillary thyroid carcinoma. World J Surg. 2013;37(2):376–84.CrossRefPubMed Kim HJ, Sohn SY, Jang HW, Kim SW, Chung JH. Multifocality, but not bilaterality, is a predictor of disease recurrence/persistence of papillary thyroid carcinoma. World J Surg. 2013;37(2):376–84.CrossRefPubMed
15.
Zurück zum Zitat Leboulleux S, Rubino C, Baudin E, et al. Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab. 2005;90(10):5723–9.CrossRefPubMed Leboulleux S, Rubino C, Baudin E, et al. Prognostic factors for persistent or recurrent disease of papillary thyroid carcinoma with neck lymph node metastases and/or tumor extension beyond the thyroid capsule at initial diagnosis. J Clin Endocrinol Metab. 2005;90(10):5723–9.CrossRefPubMed
16.
Zurück zum Zitat Kim H, Kim TH, Choe JH, et al. Patterns of initial recurrence in completely resected papillary thyroid carcinoma. Thyroid. 2017;27(7):908–14.CrossRefPubMed Kim H, Kim TH, Choe JH, et al. Patterns of initial recurrence in completely resected papillary thyroid carcinoma. Thyroid. 2017;27(7):908–14.CrossRefPubMed
17.
Zurück zum Zitat Hwangbo Y, Kim JM, Park YJ, et al. Long-term recurrence of small papillary thyroid cancer and its risk factors in a Korean multicenter study. J Clin Endocrinol Metab. 2017;102(2):625–33.PubMed Hwangbo Y, Kim JM, Park YJ, et al. Long-term recurrence of small papillary thyroid cancer and its risk factors in a Korean multicenter study. J Clin Endocrinol Metab. 2017;102(2):625–33.PubMed
18.
Zurück zum Zitat He LY, Wang W, Ibrahima BA, et al. The prognostic value of regional lymph node metastases in patients of Guangdong Province, China with differentiated thyroid cancer: a multicenter retrospective clinical study. Medicine. 2016;95(41):e5034.CrossRefPubMedPubMedCentral He LY, Wang W, Ibrahima BA, et al. The prognostic value of regional lymph node metastases in patients of Guangdong Province, China with differentiated thyroid cancer: a multicenter retrospective clinical study. Medicine. 2016;95(41):e5034.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Lee YA, Jung HW, Kim HY, et al. Pediatric patients with multifocal papillary thyroid cancer have higher recurrence rates than adult patients: a retrospective analysis of a large pediatric thyroid cancer cohort over 33 years. J Clin Endocrinol Metabol. 2015;100(4):1619–29.CrossRef Lee YA, Jung HW, Kim HY, et al. Pediatric patients with multifocal papillary thyroid cancer have higher recurrence rates than adult patients: a retrospective analysis of a large pediatric thyroid cancer cohort over 33 years. J Clin Endocrinol Metabol. 2015;100(4):1619–29.CrossRef
20.
Zurück zum Zitat Ito Y, Kudo T, Kobayashi K, Miya A, Ichihara K, Miyauchi A. Prognostic factors for recurrence of papillary thyroid carcinoma in the lymph nodes, lung, and bone: analysis of 5,768 patients with average 10-year follow-up. World J Surg. 2012;36(6):1274–8.CrossRefPubMed Ito Y, Kudo T, Kobayashi K, Miya A, Ichihara K, Miyauchi A. Prognostic factors for recurrence of papillary thyroid carcinoma in the lymph nodes, lung, and bone: analysis of 5,768 patients with average 10-year follow-up. World J Surg. 2012;36(6):1274–8.CrossRefPubMed
21.
Zurück zum Zitat Park JS, Chang JW, Liu L, Jung SN, Koo BS. Clinical implications of microscopic extrathyroidal extension in patients with papillary thyroid carcinoma. Oral Oncol. 2017;72:183–7.CrossRefPubMed Park JS, Chang JW, Liu L, Jung SN, Koo BS. Clinical implications of microscopic extrathyroidal extension in patients with papillary thyroid carcinoma. Oral Oncol. 2017;72:183–7.CrossRefPubMed
22.
Zurück zum Zitat Yin D-T, Yu K, Lu R-Q, Li X, Xu J, Lei M. Prognostic impact of minimal extrathyroidal extension in papillary thyroid carcinoma. Medicine. 2016;95(52):e5794.CrossRefPubMedPubMedCentral Yin D-T, Yu K, Lu R-Q, Li X, Xu J, Lei M. Prognostic impact of minimal extrathyroidal extension in papillary thyroid carcinoma. Medicine. 2016;95(52):e5794.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Diker-Cohen T, Hirsch D, Shimon I, Bachar G, Akirov A, Duskin-Bitan H, et al. Impact of minimal extra-thyroid extension in differentiated thyroid cancer: systematic review and meta-analysis. J Clin Endocrinol Metab. Epub 1 Mar 2018. https://doi.org/10.1210/jc.2018-00081 Diker-Cohen T, Hirsch D, Shimon I, Bachar G, Akirov A, Duskin-Bitan H, et al. Impact of minimal extra-thyroid extension in differentiated thyroid cancer: systematic review and meta-analysis. J Clin Endocrinol Metab. Epub 1 Mar 2018. https://​doi.​org/​10.​1210/​jc.​2018-00081
25.
Zurück zum Zitat Lee TY, Lee S, Bae JS. Staging of differentiated thyroid cancer from a single institution: comparison of the 7th and 8th editions of AJCC/UICC staging. J Endocr Surg. 2017;17(2):80–8.CrossRef Lee TY, Lee S, Bae JS. Staging of differentiated thyroid cancer from a single institution: comparison of the 7th and 8th editions of AJCC/UICC staging. J Endocr Surg. 2017;17(2):80–8.CrossRef
26.
Zurück zum Zitat Roti E, degli Uberti EC, Bondanelli M, Braverman LE. Thyroid papillary microcarcinoma: a descriptive and meta-analysis study. Eur J Endocrinol. 2008;159(6):659–73.CrossRefPubMed Roti E, degli Uberti EC, Bondanelli M, Braverman LE. Thyroid papillary microcarcinoma: a descriptive and meta-analysis study. Eur J Endocrinol. 2008;159(6):659–73.CrossRefPubMed
27.
28.
Zurück zum Zitat Durante C, Montesano T, Torlontano M, et al. Papillary thyroid cancer: time course of recurrences during postsurgery surveillance. J Clin Endocrinol Metab. 2013;98(2):636–42.CrossRefPubMed Durante C, Montesano T, Torlontano M, et al. Papillary thyroid cancer: time course of recurrences during postsurgery surveillance. J Clin Endocrinol Metab. 2013;98(2):636–42.CrossRefPubMed
Metadaten
Titel
Risk of Recurrence in Differentiated Thyroid Cancer: A Population-Based Comparison of the 7th and 8th Editions of the American Joint Committee on Cancer Staging Systems
verfasst von
Tong Gan, MD
Bin Huang, DrPH
Quan Chen, DrPH
Heather F. Sinner, MD
Cortney Y. Lee, MD, FACS
David A. Sloan, MD, FACS, FRCSC
Reese W. Randle, MD
Publikationsdatum
04.03.2019
Verlag
Springer International Publishing
Erschienen in
Annals of Surgical Oncology / Ausgabe 9/2019
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-019-07275-1

Weitere Artikel der Ausgabe 9/2019

Annals of Surgical Oncology 9/2019 Zur Ausgabe

Health Services Research and Global Oncology

Trends in Volume–Outcome Relationship in Gastrectomies in Texas

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.