Skip to main content

Advertisement

SpringerLink
Log in

The Updated AJCC/TNM Staging System for Papillary Thyroid Cancer (8th Edition): From the Perspective of Genomic Analysis

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

Recently, the American Joint Committee on Cancer published the 8th edition of its Cancer Staging Manual with major changes regarding the staging of thyroid cancer, including the raising of the age cutoff from 45 to 55 years. Using the clinical and genetic data of 505 papillary thyroid cancer (PTC) cases, we aimed to compare overall survival (OS) and recurrence-free survival (RFS) with different age cutoff values, and also investigate the efficacy of the new staging system on a genomic level.

Methods

We downloaded gene expression data, somatic mutation profile, copy number alteration data and clinical data of 505 PTC patients from The Cancer Genome Atlas data portal. We used multiple statistical analysis and multiplatform genomic analysis to evaluate the efficacy of the 8th edition.

Results

When using 55 years as the cutoff value for analyzing RFS, the Kaplan–Meier plot showed a significant p value but not when using 45 years (p = 0.006 vs. p = 0.493), but both cutoff values were significant when analyzing OS (p = 1.1 × 10−9 with age 55 vs. p = 4.4 × 10−5 with age 45). When looking at stage-dependent survival, both the 7th and 8th edition had significant p values (p = 0.048 vs. p = 3.1 × 10−9 in RFS and p = 5.9 × 10−10 vs. p = 2.2 × 10−10 in OS). Multiplatform genomic analysis showed patients ≥55 years had 103 differently expressed genes when compared with other age groups. Signaling pathway analysis revealed that patients ≥55 years had altered pathways associated with aggressiveness of thyroid cancer.

Conclusion

In conclusion, this is the first study to show clinical and genetic evidence supporting the altered age cutoff point of 55 years in the AJCC 8th edition for PTC patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Siegel R, Ward E, Brawley O et al (2011) Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 61:212–236

    Article  Google Scholar 

  2. Davies L, Welch HG (2006) Increasing incidence of thyroid cancer in the United States, 1973–2002. JAMA 295:2164–2167

    Article  CAS  Google Scholar 

  3. Edge SB, Compton CC (2010) The American joint committee on cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol 17:1471–1474

    Article  Google Scholar 

  4. Perrier ND, Brierley JD, Tuttle RM (2018) Differentiated and anaplastic thyroid carcinoma: major changes in the American joint committee on cancer eighth edition cancer staging manual. CA Cancer J Clin. 68:55–63

    Article  Google Scholar 

  5. LA Simor R, Li MC, Ngan M, Menenzes S, Zhao Y (2007) Analysis of gene expression data using BRB-array Tools. Cancer Inform 4(7): 11–21

    Google Scholar 

  6. Eisen MB, Spellman PT, Brown PO et al (1998) Cluster analysis and display of genome-wide expression patterns. Proc Natl Acad Sci USA 95(8): 14863–14866

    Article  CAS  Google Scholar 

  7. Cady B, Rossi R (1988) An expanded view of risk-group definition in differentiated thyroid carcinoma. Surgery 104(3): 947–995

    CAS  PubMed  Google Scholar 

  8. Hay ID, Bergstralh EJ, Goellner JR et al (1993) Predicting outcome in papillary thyroid carcinoma: development of a reliable prognostic scoring system in a cohort of 1779 patients surgically treated at one institution during 1940 through 1989. Surgery 114:1050–1057 (discussion 1057–1058)

    CAS  PubMed  Google Scholar 

  9. Shaha AR, Loree TR, Shah JP (1994) Intermediate-risk group for differentiated carcinoma of thyroid. Surgery 116:1036–1040 (discussion 1040–1031)

    CAS  PubMed  Google Scholar 

  10. Kim H, Jung HJ, Lee SY et al (2016) Prognostic factors of locally invasive well-differentiated thyroid carcinoma involving the trachea. Eur Arch Oto-Rhino-Laryngol 273(6): 1919–1920

    Article  Google Scholar 

  11. Moritani S (2015) Surgical management of cricotracheal invasion by papillary thyroid carcinoma. Ann Surg Oncol 22:4002–4007

    Article  Google Scholar 

  12. Hotomi M, Sugitani I, Toda K et al (2012) A novel definition of extrathyroidal invasion for patients with papillary thyroid carcinoma for predicting prognosis. World J Surg 36:1231–1240. https://doi.org/10.1007/s00268-012-1518-z

    Article  PubMed  Google Scholar 

  13. Kweon KH, Lee CR, Jung SJ et al (2014) Sirt1 induction confers resistance to etoposide-induced genotoxic apoptosis in thyroid cancers. Int J Oncol 45:2065–2075

    Article  CAS  Google Scholar 

  14. Qu N, Hu JQ, Liu L et al (2017) SIRT6 is upregulated and associated with cancer aggressiveness in papillary thyroid cancer via BRAF/ERK/Mcl1 pathway. Int J Oncol 50:1683–1692

    Article  CAS  Google Scholar 

  15. Gu Y, Liu X, Yu Y et al (2014) Association of ATM Gene Polymorphism with PTC Metastasis in Female Patients. Int J Endocrinol 2014:370825

    Article  Google Scholar 

  16. Kang J, Deng XZ, Fan YB et al (2014) Relationships of FOXE1 and ATM genetic polymorphisms with papillary thyroid carcinoma risk: a meta-analysis. Tumour Biol 35:7085–7096

    Article  CAS  Google Scholar 

  17. Giaginis C, Tsoukalas N, Alexandrou P et al (2017) Clinical significance of farnesoid X receptor expression in thyroid neoplasia. Future Oncol 13(2): 1785–1790

    Article  CAS  Google Scholar 

  18. Steinschneider M, Muallem Kalmovich L, Koren S, et al (2017) Reassessment of differentiated thyroid cancer patients using the 8th TNM classification system: a comparative study Thyroid: Official Journal of the American Thyroid Association 2017

  19. Lamartina L, Grani G, Arvat E, et al (2017) 8th edition of AJCC/TNM staging system of thyroid cancer: what to expect Endocrine-related cancer 2017

  20. Suh S, Kim YH, Goh TS et al (2017) Outcome prediction with the revised American joint committee on cancer staging system and American thyroid association guidelines for thyroid cancer. Endocrine 58(2): 495–450

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We appreciate the patients and their families who generously donated their tissues to TCGA, as well as the members of TCGA who collected and disclosed valuable data.

Funding

This research was supported by Hallym University Research Fund 2018 (H20180239).

Author information

Author notes

  1. Dong Jin Lee

    Present address: Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 150-950, South Korea

Authors and Affiliations

  1. Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, 1 Singil-ro, Yeongdeungpo-gu, Seoul, 150-950, South Korea

    Kyubo Kim, Jin Hwan Kim, Il Seok Park, Young Soo Rho & Gee Hwan Kwon

Authors
  1. Kyubo Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jin Hwan Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Il Seok Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Young Soo Rho
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Gee Hwan Kwon
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Dong Jin Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Ethics declarations

Conflict of interest

All authors have no conflict of interest to declare.

Electronic supplementary material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kim, K., Kim, J.H., Park, I.S. et al. The Updated AJCC/TNM Staging System for Papillary Thyroid Cancer (8th Edition): From the Perspective of Genomic Analysis. World J Surg 42, 3624–3631 (2018). https://doi.org/10.1007/s00268-018-4662-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-018-4662-2

Search

Navigation