A relook at the 8th edition of the AJCC TNM staging system of anaplastic thyroid carcinoma: A SEER‐based study

Abstract

Objective In the 8th edition American Joint Committee on Cancer (AJCC) tumour‐node‐metastasis (TNM) staging system (TNM‐8), changes have been made regarding anaplastic thyroid carcinoma (ATC) compared with the 7th edition (TNM‐7). The major changes are that anaplastic ATC now has the same T stage definitions as differentiated thyroid cancer, and new staging of IVA and IVB is implemented. However, the clinical impact of the new edition for ATC remains unclear due to scarce and conflicting data. In this study, we compared the AJCC TNM‐7 and TNM‐8 in the same group of patients. Design In this retrospective study, we included patients who were diagnosed with ATC between 2004 and 2015; data were gathered from the Surveillance, Epidemiology and End Results (SEER) database. Methods Overall survival (OS) was evaluated according to T stage and TNM stage according to the 7th and 8th editions. Kaplan–Meier and log‐rank testing was used to analyse OS. The effect of potential predictors was estimated using the Cox regression model. Results We included 669 patients in the study. The median age of the cohort was 70 years. During the follow‐up, 600 (89.7%) patients died, 528 of whom died of thyroid cancer. The TNM‐8 T staging more effectively predicted survival than the 7th edition (proportion of variation explained: 3.53% vs. 1.72%). However, the clinical stage was almost unchanged according to the TNM‐8 (proportion of variation explained: 10.69% vs. 10.73%). Conclusions The new T classification is an effective predictor of survival for patients with ATC. The results support the use of T definitions as per those of differentiated thyroid cancer. However, whether lymph node metastasis should be taken into account for defining ATC TNM staging should be reconsidered.

Clinicopathological features and prognostic factors analysis of multiple synchronous distinct subtypes of primary thyroid carcinoma

“…The same case involves different histological subtypes of thyroid cancer, so we can further study the clinicopathological characteristics of different STC by classifying these subtype combinations. The results showed that the age of SDDTC was younger than that of SMDTC and SADTC, and the average age at diagnosis of SADTC was the largest, followed by SMDTCr, which was similar to the age analysis results of singleton thyroid cancer [31][32][33] .There was no statistically significant gender difference among the three groups，SADTC not only has a longer maximum tumor diameter than SDDTC and SMDTC, but also has a significantly longer disease duration than SDDTC and SMDTC, previously reported that anaplastic carcinoma is highly aggressive, progresses rapidly, and the neck mass expands rapidly [34] .However, the SADTC in our case has a longer course of disease, up to 20 years. There are existing reports on SADTC and the course of the disease are also more than 20 years [9,12] , may be due to undifferentiated progression from differentiated [35] .…”

The role of surgery for anaplastic thyroid carcinoma in the era of targeted therapeutics: A scoping review

“…All patients with ATC are stage IV by definition irrespective of disease extent. Intrathyroidal disease is staged as IVA, extrathyroidal or locoregional disease is staged as IVB, while metastatic disease is staged as IVC 7 . According to the 2021 American Thyroid Association (ATA) guidelines for management of patients with ATC, those with stage IVA and ‘resectable’ stage IVB disease should be offered upfront surgical resection 8 .…”

“…7,8 Given the lack of clarity in the literature regarding what resections have been attempted and what extent of disease patients have preoperatively, especially in stage IVB disease, it…”

Evaluation of anaplastic thyroid carcinoma in the Kurdistan region of Iraq

“…Anaplastic thyroid carcinoma (ATC) is an uncommon but profoundly aggressive thyroid malignancy established in undifferentiated follicular thyroid cells [ 1 , 2 ]. It accounts for more than 50% of all deaths attributable to thyroid tumours, with a mean survival period of three to four months and disease-specific mortality at one year of about 100% [ 1 , 3 ].…”

“…Anaplastic thyroid carcinoma (ATC) is an uncommon but profoundly aggressive thyroid malignancy established in undifferentiated follicular thyroid cells [1,2]. It accounts for more than 50% of all deaths attributable to thyroid tumours, with a mean survival period of three to noteworthy nearby compressive symptoms due to a quickly advancing central neck mass (77%), accompanying dysphagia (40%), hoarseness (40%), and stridor (24%).…”