The update of AJCC/TNM staging system may change the post-operative assessment of differentiated thyroid cancer / 中华内分泌代谢杂志

ABSTRACT

Objective To investigate the post-operative mortality risk staging changes of differentiated thyroid cancer resulted from the changes of the AJCC/TNM cancer staging system and to explore its clinical significance. Methods This study included 2 553 patients accepting surgical therapies in Department of Thyroid Surgery from January 2013 to February 2017. Overall,2 553 patients were staged according to the 7th and 8th editions of the AJCC/TNM cancer staging system respectively. Results Compared with the previous staging outcomes,548 patients(21.46%)were downstaged according to the 8th edition of the staging system. Of these 548 patients,438 (17.16%)migrated from an advanced stage(Ⅲ/Ⅳ)to stage Ⅰ/Ⅱ. The difference of the staging outcomes was significant(P<0.01). Because of the change of age cut off,364 patients(14.26%)were downstaged to stage I. Of these 364 patients, 318(12. 46%) migrated from an advanced stage(Ⅲ/Ⅳ) to stage I. Conclusion For the changes of the AJCC/TNM cancer staging system,particularly for the change of age cut off,many patients with DTC would be referred to lower stages, and therefore they would receive less aggressive post-operative management strategies.