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자료유형
학술저널
저자정보
김미진 (부산대학교병원) 김원구 (울산대학교) 전민지 (울산대학교) 김희경 (전남대학교) 이현승 (충남대학교) 김은숙 (울산대학교) 김보현 (부산대학교) 김원배 (울산대학교) 송영기 (울산대학교) 강호철 (전남대학교) 김태용 (울산대학교)
저널정보
대한내분비학회 Endocrinology and Metabolism Endocrinology and Metabolism Vol.35 No.1
발행연도
2020.1
수록면
149 - 156 (8page)

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Background: Concerns have arisen about the classification of extra-thyroidal extension (ETE) and lateral cervical lymph node metastasis (N1b) in the 8th edition of the tumor-node-metastasis staging system (TNM-8). This study evaluated the prognostic validityof a modified-TNM staging system, focusing on ETE and N1b, in differentiated thyroid carcinoma (DTC) patients. Methods: This multicenter retrospective cohort study included 4,878 DTC patients from five tertiary hospitals. In the modifiedTNM, T3b in TNM-8 was down-staged to T2, and stage II was subdivided into stages IIA and IIB. Older patients with N1b were reclassified as stage IIB. Results: The modified-TNM resulted in staging migration in 540 patients (11%) classified as stage II according to the TNM-8, with75 (14%), 381 (71%), and 84 patients (16%) classified as stages I, IIA, and IIB, respectively. The 10-year disease-specific survival(DSS) rates in patients classified as stages I, II, III, and IV by TNM-8 were 99.8%, 95.9%, 81.0%, and 41.6%, respectively. The DSSrates of patients classified as stages I, IIA, IIB, III, and IV according to the modified-TNM were 99.8%, 96.4%, 93.3%, 81.0%, and41.6%, respectively. DSS curves between stages on TNM-8 (P<0.001) and modified-TNM (P<0.001) differed significantly, but themodified-TNM discriminated better than TNM-8. The proportions of variation explained values of TNM-8 and modified-TNM were6.3% and 6.5%, respectively. Conclusion: Modification of the TNM staging system focusing on ETE and N1b could improve the prediction of DSS in patientswith DTC. Further researches are needed to validate the prognostic accuracy of this modified-TNM staging system.

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