An Analysis of The American Joint Committee on Cancer 8th Edition T Staging System for Papillary Thyroid Carcinoma

Tran, Bryan; Roshan, David; Abraham, Earl; Wang, Laura; Garibotto, Natalia; Wykes, James; Campbell, Peter; Ebrahimi, Ardalan

doi:10.1210/jc.2017-02551

Cited by 43 publications

(39 citation statements)

References 21 publications

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“…Following the publishing of the 8th AJCC staging system, it also caused widespread controversy. Many researchers have presented different views against the new staging system, as they consider that mETE can increase the risk of thyroid carcinoma recurrence (45). In the 8th AJCC staging system, any lymph node involvement in either the central or lateral neck defines a patient as stage group II (in the absence of gross extrathyroidal extension or distant metastases) in patients aged 55 years or older.…”

Section: Discussionmentioning

confidence: 99%

Low expression of ryanodine receptor 2 is associated with poor prognosis in thyroid carcinoma

Zhang

Chen

et al. 2019

Oncol Lett

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Genetic alterations are vital in the progression of thyroid carcinoma. Ryanodine receptor 2 (RyR2) is reported to serve an important role in several types of human carcinoma. However, the expression and effect of RyR2 in thyroid carcinoma remain unknown. Therefore, the present study analyzed the status of RyR2 in thyroid carcinoma using bioinformatics tools. The mRNA profiles of thyroid carcinoma were downloaded from The Cancer Genome Atlas. RyR2 was distinguished as a differentially expressed gene that has not been reported in thyroid carcinoma. Further analysis indicated that there was selective downregulation of RyR2 expression in thyroid carcinoma tissues compared with that in normal thyroid tissues. Survival analysis showed that RyR2 expression was associated with poorer disease-free survival (DFS) for all patients with thyroid carcinoma. Univariate analysis revealed that a low expression of RyR2 was significantly associated with lymphatic metastasis, extracapsular extension, and the Tumor-Node-Metastasis stage. Cox analysis demonstrated that RyR2 was an independent prognostic factor in thyroid carcinoma for DFS. The biological processes and signaling pathways of RyR2 were reviewed with Gene Set Enrichment Analysis. In conclusion, the present study has revealed that RyR2 is downregulated in thyroid carcinoma, and that low expression of RyR2 is associated with poor prognosis in patients with thyroid carcinoma. RyR2 may therefore serve as a promising tumor suppressor gene in thyroid carcinoma.

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Section: Discussionmentioning

confidence: 99%

Low expression of ryanodine receptor 2 is associated with poor prognosis in thyroid carcinoma

Zhang

Chen

et al. 2019

Oncol Lett

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“…It was found that mETE was strongly associated with adverse prognostic factors and reduced disease‐free survival (hazard ratio 2.8) after controlling for tumor size. mETE was found to confer a 2.24‐fold increase in risk of recurrence in all ages . Amit et al also suggested that mETE acts as a predictor of locoregional recurrence and that the distinction between gross versus microscopic ETE may not be enough to impact postoperative risk stratification .…”

Section: Discussionmentioning

confidence: 99%

Unexpected high‐risk pathologic features following thyroidectomy in the chinese immigrant population

et al. 2019

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Objective To compare rates of unexpected high‐risk pathologic features between Chinese and non‐Asian patients who underwent thyroidectomy for papillary thyroid cancer. Methods This was a retrospective cohort study at a tertiary academic urban medical center. Patients who underwent thyroidectomy for papillary carcinoma from 2015 to 2017 were included. Patient demographics, tumor characteristics, and tumor histopathology were analyzed. Primary outcome was the presence of adverse histopathologic features such as lymphovascular invasion (LVI) or microscopic/minimal extrathyroidal extension (mETE). Differences between the groups were analyzed using multivariate logistical regression analysis and propensity score‐weighted analysis. Results One hundred seventy‐nine patients were included: 58 Chinese‐born and 121 non‐Asian. The median age of the cohort was 47 years old (36–58). Twenty‐nine percent of patients were male, and 71% were female. There was no statistically significant difference between the two cohorts in rates of LVI, multifocality, extent of surgery, or presence of thyroiditis. Patients with mETE were more likely to have larger tumors (P = 0.00247). Both the multivariate and propensity‐weighted models demonstrated that Chinese ancestry was independently associated with an increased rate of unexpected mETE (adjusted prevalence ratio, 2.52; 95% confidence interval, 1.82–3.48). Conclusion mETE is significantly higher in the immigrant Chinese compared to the non‐Asian population. Given the high prevalence of unexpected mETE in the Chinese population, the added risk of this finding should be brought into the discussion during initial surgical planning. Level of Evidence 3 Laryngoscope, 130:1844–1849, 2020

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“…Most studies have incorporated age into binary variables with a distinct cutoff point for DTC patients (18). In 2018, the 8th edition of the Staging System for Primary Tumors set by the American Joint Committee on Cancer adjusted the age cutoff point from 45 to 55 years, raising concerns among pathologists and clinicians (19–21). Recent studies using age as a continuous variable rather than a dichotomic factor found better concordance with survival and death from TC (22, 23).…”

Section: Introductionmentioning

confidence: 99%

Association of the Cumulative Dose of Radioactive Iodine Therapy With Overall Survival in Patients With Differentiated Thyroid Cancer and Pulmonary Metastases

et al. 2019

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Purpose: The optimal cumulative dose of radioactive iodine therapy (RAIT) for patients with differentiated thyroid cancer (DTC) and pulmonary metastases (PM) is not known, therefore we evaluated the association between the cumulative dose of RAIT and overall survival (OS). Methods: A total of 202 patients with DTC and PM who underwent thyroidectomy and RAIT were analyzed in this study. The median cumulative dose of RAIT was 530 mCi. OS was compared with an age- and sex-matched general population from China to assess relative survival. Multivariable proportional hazards model smoothing by penalized spline was applied to identify independent predictors and examine the adjusted non-linear association of cumulative dose of RAIT and patient age with mortality. Results: The observed survival and relative survival at 10 years was 54.96 and 60.81%, respectively, with the standardized mortality ratio being 5.34. The cumulative dose of RAIT was associated with mortality in a dose-dependent fashion without an apparent cutoff point after adjustment of other variables. A linear but moderate association was found in the dose of 300 to 1,000 mCi. Cumulative dose of RAIT, patient age, diameter of pulmonary metastases, and extrapulmonary metastases were identified as independent predictors for OS. The increasing patient age was associated with mortality in a non-linear pattern, with the optimal threshold being 40 years. With advancing age, the risk of death increases rapidly in patients aged 40 years and younger, but slowly in patients over 40 years. Conclusions: RAIT should be assigned to RAI-avid patients until disease has been controlled or RAIT becomes refractory after consideration of the potential long-term side-effects. Patient age was associated with OS in a non-linear pattern, with a threshold at 40 years. Consideration of age as a binary variable could elucidate a more accurate prognosis in such patients.

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An Analysis of The American Joint Committee on Cancer 8th Edition T Staging System for Papillary Thyroid Carcinoma

Cited by 43 publications

References 21 publications

Low expression of ryanodine receptor 2 is associated with poor prognosis in thyroid carcinoma

Low expression of ryanodine receptor 2 is associated with poor prognosis in thyroid carcinoma

Unexpected high‐risk pathologic features following thyroidectomy in the chinese immigrant population

Association of the Cumulative Dose of Radioactive Iodine Therapy With Overall Survival in Patients With Differentiated Thyroid Cancer and Pulmonary Metastases

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