Evaluation of the 8th Edition TNM Classification for Anaplastic Thyroid Carcinoma
Abstract
:1. Introduction
2. Results
3. Discussion
4. Materials and Methods
4.1. Patients
4.2. Statistical Analyses
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Stage | 7th Edition | 8th Edition |
---|---|---|
IV A | T4a, any N and M0 T4a: The cancer is any size but confined to the thyroid | T1–3a, N0 and M0 T1: Tumor ≤ 2 cm in greatest dimension limited to the thyroid T2: Tumor > 2 cm but ≤ 4 cm in greatest dimension limited to the thyroid T3a: Tumor > 4 cm limited to the thyroid |
IV B | T4b, any N and M0 T4b: The cancer is extended outside of the thyroid gland to any extent | T1–3a, N1 and M0 Or T3b–T4b, any N and M0 T3b: Gross extrathyroidal extension invading only strap muscles (sternohyoid, sternothyroid, thyrohyoid, or omohyoid muscles) from a tumor of any size T4a: Gross extrathyroidal extension invading subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve from a tumor of any size T4b: Gross extrathyroidal extension invading prevertebral fascia or encasing a carotid artery or mediastinal vessels from a tumor of any size |
IV C | Any T, any N and M1 | Any T, any N and M1 |
Factor | No. | % | Median Overall Survival Months 95%CI (Range) | Log-Rank Test p-Value | |
---|---|---|---|---|---|
Age: | Median 71.0 (28–96) yrs | ||||
<70 yrs | 349 | 46.1% | 5.0 (4.3–6.0) | 0.01 | |
≥70 yrs | 408 | 53.9% | 4.6 (3.8–5.3) | ||
Sex: | |||||
Male | 305 | 40.3% | 4.9 (3.8–5.8) | 0.74 | |
Female | 452 | 59.7% | 4.6 (4.1–5.4) | ||
T (7th edn.): | |||||
4a | 168 | 22.2% | 7.5 (5.7–8.9) | < 0.01 | |
4b | 589 | 77.8% | 4.3 (3.7–4.7) | ||
T (8th edn.): | |||||
1 | 8 | 1.1% | 12.5 (0.9–16.8) | n.s. 1 vs. others | |
2 | 43 | 5.7% | 10.9 (8.2–17.7) | 0.03 vs. T3a <0.01 vs. T3b and T4 | |
3a | 117 | 15.5% | 5.7 (4.3–7.3) | <0.01 vs. T3b 0.03 vs. T4 | |
3b | 438 | 57.9% | 3.9 (3.4–4.5) | 0.66 vs. T4 | |
4a and 4b | 151 | 19.9% | 5.0(3.8–6.4) | ||
N: | |||||
0 | 224 | 29.6% | 5.9 (4.8–7.0) | <0.01 | |
1 | 533 | 70.4% | 4.3 (3.7–4.9) | ||
M: | |||||
0 | 467 | 61.7% | 6.6 (5.9–7.3) | <0.01 | |
1 | 290 | 38.3% | 2.8 (2.3–3.3) | ||
Stage (7th edn.): | |||||
IV A | 108 | 14.3% | 10.6 (7.7–13.3) | <0.01 between each | |
IV B | 359 | 47.4% | 6.0 (5.2–6.6) | ||
IV C | 290 | 38.3% | 2.8 (2.3–3.3) | ||
Stage (8th edn.): | |||||
IV A | 45 | 5.9% | 15.8 (8.5–27.6) | <0.01 between each | |
IV B | 422 | 55.7% | 6.1 (5.7–6.8) | ||
IV C | 290 | 38.3% | 2.8 (2.3–3.3) |
T | 3 Mos. | 6 Mos. | 12 Mos. |
---|---|---|---|
1 | 71.4% ± 17.1% | 71.4% ± 17.1% | 42.9% ± 18.7% |
2 | 80.2 % ± 6.3% | 72.7% ± 7.0% | 47.1% ± 8.0% |
3a | 74.7% ± 4.1% | 45.7% ± 4.7% | 25.9% ± 4.2% |
3b | 61.4% ± 2.4% | 35.7% ± 2.4% | 17.1% ± 1.9% |
4 | 65.1% ± 4.0% | 41.6% ± 4.3% | 16.9% ± 3.3% |
Stage | 3 Mos. | 6 Mos. | 12 Mos. |
---|---|---|---|
IV A, 7th edn. | 86.5% ± 3.3% | 67.7% ± 4.6% | 43.6% ± 5.0% |
IV B, 7th edn. | 74.5% ± 2.4% | 48.8% ± 2.7% | 24.6% ± 2.4% |
IV A, 8th edn. | 90.7% ± 4.4% | 74.0% ± 6.8% | 52.5% ± 7.7% |
IV B, 8th edn. | 75.9% ± 2.1% | 50.8% ± 2.5% | 26.6% ± 2.3% |
IV C, 7th and 8th edn. | 46.0% ± 3.0% | 21.1% ± 2.5% | 6.6% ± 1.6% |
Factors | Univariate | Multivariate | ||||
---|---|---|---|---|---|---|
HR | 95% CI | p | HR | 95% CI | p | |
Age < 70 vs. ≥ 70 yrs. | 1.3 | 1.1–1.5 | 0.002 | 1.3 | 1.1–1.5 | 0.002 |
Male vs. female | 1.1 | 0.9–1.3 | 0.323 | |||
T4b vs. T4a | 1.5 | 1.1–2.1 | 0.008 | 1.6 | 1.3–2.1 | 0.004 |
N1 vs. N0 | 1.2 | 1.0–1.5 | 0.016 | |||
M1 vs. M0 | 2.5 | 1.7–3.5 | 0.000 | |||
Stage IV B vs. IV A | 1.1 | 0.7–1.6 | 0.688 | 1.1 | 0.73–1.6 | 0.744 |
Stage IV C vs. IV A | NA 1 | NA–NA | NA | 2.5 | 1.73–3.5 | < 0.001 |
Factors | Univariate | Multivariate | ||||
---|---|---|---|---|---|---|
HR | 95% CI | p | HR | 95% CI | p | |
Age <70 vs. ≥ 70 yrs. | 1.3 | 1.1–1.6 | 0.001 | 1.3 | 1.1–1.5 | 0.002 |
Male vs. female | 1.1 | 0.9–1.3 | 0.306 | |||
T2 vs. T1 | 0.6 | 0.3–1.4 | 0.273 | |||
T3a vs. T1 | 1.0 | 0.5–2.2 | 0.934 | |||
T3b vs. T1 | 1.4 | 0.7–3.0 | 0.369 | |||
T4b vs. T1 | 1.2 | 0.5–2.5 | 0.703 | |||
N1 vs. N0 | 1.2 | 1.0–1.5 | 0.030 | |||
M1 vs. M0 | 3.0 | 1. 9–4.6 | 0.000 | |||
Stage IV B vs. IV A | 1.3 | 0.8–2.0 | 0.279 | 2.1 | 1.4–3.0 | < 0.001 |
Stage IV C vs. IV A | NA 1 | NA–NA | NA | 4.5 | 3.0–6.6 | < 0.001 |
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Onoda, N.; Sugitani, I.; Ito, K.-i.; Suzuki, A.; Higashiyama, T.; Fukumori, T.; Suganuma, N.; Masudo, K.; Nakayama, H.; Uno, A.; et al. Evaluation of the 8th Edition TNM Classification for Anaplastic Thyroid Carcinoma. Cancers 2020, 12, 552. https://doi.org/10.3390/cancers12030552
Onoda N, Sugitani I, Ito K-i, Suzuki A, Higashiyama T, Fukumori T, Suganuma N, Masudo K, Nakayama H, Uno A, et al. Evaluation of the 8th Edition TNM Classification for Anaplastic Thyroid Carcinoma. Cancers. 2020; 12(3):552. https://doi.org/10.3390/cancers12030552
Chicago/Turabian StyleOnoda, Naoyoshi, Iwao Sugitani, Ken-ichi Ito, Akifumi Suzuki, Takuya Higashiyama, Tatsuya Fukumori, Nobuyasu Suganuma, Katsuhiko Masudo, Hirotaka Nakayama, Atsuhiko Uno, and et al. 2020. "Evaluation of the 8th Edition TNM Classification for Anaplastic Thyroid Carcinoma" Cancers 12, no. 3: 552. https://doi.org/10.3390/cancers12030552