Stage migration with the new American Joint Committee on Cancer (AJCC) staging system (8th edition) for differentiated thyroid cancer Journal Article


Authors: Shaha, A. R.; Migliacci, J. C.; Nixon, I. J.; Wang, L. Y.; Wong, R. J.; Morris, L. G. T.; Patel, S. G.; Shah, J. P.; Tuttle, R. M.; Ganly, I.
Article Title: Stage migration with the new American Joint Committee on Cancer (AJCC) staging system (8th edition) for differentiated thyroid cancer
Abstract: Background: Tumor, node, and metastasis staging in thyroid carcinoma is important for assessing prognosis. However, patients with stage III or IV disease have an overall survival rate of 90%. The change to 55 years of age as the cutoff will create stage migration and many patients will be downstaged. Methods: We reviewed our database of 3,650 patients to analyze the impact of the new American Joint Committee on Cancer staging system. There were 994 men (27%) and 2,656 women (73%). The median age was 46 years. Patients were staged using both 7th and 8th editions, with a cutoff of 55 years of age and new definitions of T3 and T4, and nodal staging. Results: Of 3,650 patients, 1,057 (29%) were downstaged. There were 104 (10%) who went from stage IV to I, 109 (10%) who went from stage IV to stage II, and 68 (6%) who went to stage III. There were 218 (21%) who went from stage III to I, 347 (33%) who went from stage III to stage II, and 211 (20%) who went from stage II to I. The overall disease-specific and relapse-free survival was analyzed and showed better stratification with the new staging system. Conclusion: The new staging system reflects more appropriately the biology of thyroid cancer and will have significant impact on the management of thyroid cancer. © 2018 Elsevier Inc.
Keywords: adolescent; adult; cancer survival; child; aged; survival rate; major clinical study; disease free survival; cancer staging; prospective study; tumor differentiation; sex difference; thyroid cancer; age distribution; recurrence free survival; very elderly; human; male; female; priority journal; article
Journal Title: Surgery
Volume: 165
Issue: 1
ISSN: 0039-6060
Publisher: Elsevier Inc.  
Date Published: 2019-01-01
Start Page: 6
End Page: 11
Language: English
DOI: 10.1016/j.surg.2018.04.078
PROVIDER: scopus
PMCID: PMC6309303
PUBMED: 30415873
DOI/URL:
Notes: Surgery -- Export Date: 2 January 2019 -- Article -- CODEN: SURGA C2 - 30415873 -- Source: Scopus
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MSK Authors
  1. Ashok R Shaha
    528 Shaha
  2. Snehal G Patel
    284 Patel
  3. Robert M Tuttle
    344 Tuttle
  4. Iain James Nixon
    60 Nixon
  5. Richard J Wong
    223 Wong
  6. Luc Morris
    121 Morris
  7. Ian Ganly
    227 Ganly
  8. Jatin P Shah
    527 Shah
  9. Laura Wang
    34 Wang