Evaluation of the 8th Edition TNM Classification for Anaplastic Thyroid Carcinoma
Evaluation of the 8th Edition TNM Classification for Anaplastic Thyroid Carcinoma
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DOI：
10.3390/cancers12030552
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发表时间：
2020-03-01
期刊：
影响因子：
5.2
通讯作者：
Suzuki, Shinichi
中科院分区：
文献类型：
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作者：
Onoda, Naoyoshi;Sugitani, Iwao;Suzuki, Shinichi
背景：对甲状腺未分化癌（ATC）的肿瘤淋巴结转移（TNM）分类系统进行了修订。方法：使用ATC患者的大型数据库对修订后的系统进行评估。结果：共分析了757例患者。比例和中位总生存期值每个T类别的（OS：月）为T1（n = 8，1.1%，12.5）、T2（n = 43，5.7%，10.9）、T3a（n = 117，15.5%，5.7）、T3b（n = 438，57.9%，3.9）和T4（n = 151，19.9%，5.0）。N0和N1患者的OS分别为5.9和4.3（对数秩p < 0.01）。63例（58.3%）患者根据淋巴结受累的存在通过翻修从IVA期迁移至IV B期，422例（55.7%）患者分层至IV B期，OS未恶化（6.1），45例（5.9%）患者为IV A期，OS一般（15.8）。IV期B患者与IVA期患者相比的生存风险比在翻修时从1.1增加到2.1。IV C期无变化（n = 290，38.8%，2.8）。结论：修订后的TNM系统通过提取罕见的具有一般诊断的患者为IVA期疾病并将许多异质性患者分类为IV期B，清楚地显示了ATC患者的诊断。
Background: The tumor-node-metastasis (TNM) classification system to categorized anaplastic thyroid cancer (ATC) was revised. Methods: The revised system was evaluated using a large database of ATC patients. Results: A total of 757 patients were analyzed. The proportion and median overall survival values (OS: months) for each T category were T1 (n = 8, 1.1%, 12.5), T2 (n = 43, 5.7%, 10.9), T3a (n = 117, 15.5%, 5.7), T3b (n = 438, 57.9%, 3.9), and T4 (n = 151, 19.9%, 5.0). The OS of the N0 and N1 patients were 5.9 and 4.3, respectively (log-rank p < 0.01). Sixty-three (58.3%) patients migrated from stage IVA to IV B by revision based on the existence of nodal involvement and 422 patients (55.7%) were stratified into stage IV B, without a worsening of their OS (6.1), leaving 45 patients (5.9%) in stage IV A with fair OS (15.8). The hazard ratios for the survival of the patients of stage IV B compared to stage IVA increased from 1.1 to 2.1 by the revision. No change was made for stage IV C (n = 290, 38.8%, 2.8). Conclusion: The revised TNM system clearly indicated the prognoses of ATC patients by extracting rare patients with fair prognoses as having stage IVA disease and categorized many heterogeneous patients in stage IV B.