Association between TNM staging system and histopathological features in patients with papillary thyroid carcinoma

Abstract

We aimed to assess the validity of the American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system in patients with papillary thyroid carcinoma (PTC) by evaluating the relationships between clinicopathologic factors and TNM stage using histopathological specimens and electronic medical records. We enrolled 733 consecutive patients who had undergone thyroid surgery for PTC between 2010 and 2013. Clinical data were obtained from electronic medical records. TNM stages, multifocality, and bilaterality were analyzed after review of histopathological specimens by applying the AJCC TNM staging system. Multiple statistical analyses were performed to evaluate the correlation between the AJCC TNM staging system and the clinicopathologic factors. Of the 733 patients, there were T stage including T1a (46.9 %, 344/733), T1b (12.6 %, 92/733), T2 (2.0 %, 15/733), T3 (38.1 %, 279/733), T4a (0.4 %, 3/733), and T4b (0 %, 0/733), N stage including N0 (58.9 %, 432/733), N1a (24.3 %, 178/733), and N1b (16.8 %, 123/733), and multiplicity including multifocality (31.1 %, 228/733) and bilaterality (23.7 %, 174/733). There was a significant association between the PTC primary tumor size and T stage, N stage, multifocality, and bilaterality (p < 0.0001). Multifocality, bilaterality, and the presence of nodal metastasis were most frequently seen in patients with T3 stage (p < 0.0001). In multivariate logistic regression analyses, T and N stages were independent predictors of multiple PTCs. The PTC primary tumor size had a significant association with the T and N stages of the AJCC TNM staging system, and these factors were independent predictors of multifocality and bilaterality.

How Many Contralateral Carcinomas in Patients with Unilateral Papillary Thyroid Microcarcinoma are Preoperatively Misdiagnosed as Benign?

“…In contrast, in our study, occult contralateral papillary carcinoma was significantly more frequent in patients with a tumor [0.5 cm according to postoperative pathology, which is consistent with the results of Lee et al [9]. In addition, Ryu et al [26] reported that PTC primary tumor size was significantly associated with T and N stages in the AJCC TNM staging system, which are independent predictors of multifocality and bilaterality. It has also been reported that patients with a tumor size[1 cm are more likely to have tumor recurrence in a regional lymph node [27].…”

Effects of tumor size on prognosis in differentiated thyroid carcinoma smaller than 2 cm

“…The relationship between tumor size and aggressive histological features was also analyzed. Multifocality, ETE, bilaterality, vascular invasion, lymph node metastases and distant metastases were compared in eight (12–14,18,19,24,25,28), five (14,18,19,22,27), three (12,18,28), four (7,12,13,18), eleven (6,7,12,14,18–20,24,28–30) and five (7,12,14,18,24) studies, respectively. Based on the meta-analysis, S2 was found to be associated with aggressive histological features more often compared with S1 , including ETE (OR=2.575, 95% CI=1.603–4.135; P <0.05) (Fig.…”

Lymph node metastasis in the space between the right carotid artery and jugular vein in papillary thyroid carcinoma

“…It has been indicated that tumor size is correlated with lymph node metastasis, extrathyroidal extension, recurrence, and poor overall survival. [8][9][10][11][12] Tumor size is also a risk factor in the American Joint Committee on Cancer TNM system. The small sample size was the primary reason for the marginal correlation seen in this study.…”