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1Division of Endocrinology and Metabolism, Department of Internal Medicine, Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
2Division of Endocrinology and Metabolism, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
3Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
4Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea.
5Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
Copyright © 2020 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.
AUTHOR CONTRIBUTIONS:
Conception or design: M.K., W.G.K., M.J.J., H.C.K., T.Y.K.
Acquisition, analysis, or interpretation of data: M.K., M,J.J., H.S.Y., E.S.K., H.C.K.
Drafting the work or revising: M.K., T.Y.K.
Final approval of the manuscript: M.K., W.G.K., M.J.J., H.K.K., H.S.Y., E.S.K., B.H.K., W.B.K., Y.K.S., H.C.K., T.Y.K.
TNM-8 | Modified-TNM | |
---|---|---|
T category | ||
TX | Primary tumor cannot be assessed | Same as 8th edition |
T0 | No evidence of primary tumor | Same as 8th edition |
T1 | Tumor size ≤2 cm, limited to the thyroid | Same as 8th edition |
T2 | Tumor size >2 cm and ≤4 cm, limited to the thyroid | Tumor size >2 cm and ≤4 cm, limited to the thyroid, or gross extrathyroidal extension invading only strap muscles with tumor size ≤4 cm |
T3a | Tumor size >4 cm, limited to the thyroid | Tumor size >4 cm, limited to the thyroid |
T3b | Gross extrathyroidal extension invading only strap muscles from Gross extrathyroidal extension invading only strap muscles a tumor of any size | Gross extrathyroidal extension invading only strap muscles with tumor size >4 cm |
T4a | Gross extrathyroidal extension invading subcutaneous soft tissues, larynx, trachea, esophagus, or recurrent laryngeal nerve | Same as 8th edition |
T4b | Gross extrathyroidal extension invading prevertebral fascia, encasing the carotid artery, or mediastinal vessels | Same as 8th edition |
The definitions of N and M categories are identical | ||
Stage group | I: Tx Nx M0 <55 yr | |
T1-2 N0/NX M0 ≥55 yr | I: Tx Nx M0 <55 yr | |
II: Tx Nx M1 <55 yr | T1-2 N0/NX M0 ≥55 yr | |
T1-2 N1 M0 ≥55 yr | IIA: Tx Nx M1 <55 yr | |
T3a/T3b Nx M0 ≥55 yr | T1-2 N1a M0 ≥55 yr | |
T3a/T3b N0-1a M0 ≥55 yr | ||
IIB: T1-2 N1b M0 ≥55 yr | ||
T3a/T3b N1b M0 ≥55 yr | ||
III: T4a Nx M0 ≥55 yr | III: T4a Nx M0 ≥55 yr | |
IVA: T4b Nx M0 ≥55 yr | IVA: T4b Nx M0 ≥55 yr |
Characteristic | Value |
---|---|
Number | 4,878 |
Age, yr | 45.9±12.2 |
Female sex | 4,226 (87) |
Pathology | |
PTC | 4,704 (96) |
FTC | 174 (4) |
Primary tumor size, cm | 1.7±1.3 |
≤2 | 3,534 (72) |
2–4 | 1,116 (23) |
>4 | 228 (5) |
Extra-thyroidal extension | |
Microscopic | 1,407 (29) |
Gross, invading only strap muscle | 577 (12) |
With primary tumor size ≤4 cm | 530 |
With primary tumor size >4 cm | 47 |
Gross, invading other than strap muscle | 267 (5) |
Cervical LN metastasis | |
N1a | 1,624 (33) |
N1b | 492 (10) |
Distant metastasis | 74 (2) |
Total thyroidectomy | 3,891 (80) |
RAI treatment | 3,140 (64) |
Variable | No. (%) | 10-yr DSS rates, % | HR | 95% CI | P value | PVE, % |
---|---|---|---|---|---|---|
TNM-8 | 6.3 | |||||
Stage I | 4,214 (86) | 99.8 | 1.0 | Reference | ||
Stage II | 540 (11) | 95.9 | 23.0 | 11.6–45.6 | <0.001 | |
Stage III | 97 (2) | 81.0 | 143.0 | 68.8–297.5 | <0.001 | |
Stage IV | 27 (1) | 41.6 | 366.7 | 173.8–744.0 | <0.001 | |
Modified-TNM | 6.5 | |||||
Stage I | 4,289 (88) | 99.8 | 1.0 | Reference | ||
Stage IIA | 381 (8) | 96.4 | 16.7 | 8.1–34.0 | <0.001 | |
Stage IIB | 84 (2) | 93.3 | 38.6 | 17.4–85.4 | <0.001 | |
Stage III | 97 (2) | 81.0 | 121.1 | 60.5–242.5 | <0.001 | |
Stage IV | 27 (1) | 41.6 | 313.2 | 154.1–636.8 | <0.001 |
TNM-8, 8th edition of the AJCC TNM staging system; TNM, tumor-node-metastasis.
Values are expressed as mean±standard deviation or number (%). PTC, papillary thyroid carcinoma; FTC, follicular thyroid carcinoma; LN, lymph node; RAI, radioactive iodine.
DSS, disease-specific survival; TNM-8, 8th edition of the AJCC TNM staging system; TNM, tumor-node-metastasis; HR, hazard ratio; CI, confidence interval; PVE, proportion of variation explained.