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Outcome prediction with the revised American joint committee on cancer staging system and American thyroid
Sunghwan Suh1, Yun Hak Kim2, Tae Sik Goh3
1Department of Internal Medicine, Dong-A University College of Medicine, Busan, Republic of Korea.
Background:
Several staging systems have been developed to predict the risk of mortality in patients with differentiated thyroid cancer (DTC). However, none of them have been shown to be clearly superior to the other.
Methods:
We compared the patient outcome predictability of recently revised staging systems predictability of patient outcome using data from The Cancer Genome Atlas. To set a comparison among American Joint Committee on Cancer (AJCC)/Union for International Cancer Control (UICC) staging 7th, 8th editions, American Thyroid Association guidelines 2009 and 2015, concordance index (c-index), Akaike information criterion (AIC), Bayesian information criterion (BIC), and Brier score were applied to quantify the predictive ability of a survival model, to select the statistical model, and to measure the accuracy of probabilistic predictions.
Results:
A total of 457 patients with papillary thyroid cancer having a mean age of 45.9 years were included in this study (120 males, 337 females). Among these patients, 43 (9.4%) experienced recurrence/progression during the follow-up (591.2 ± 833.5 months). Among the models used, the AJCC/UICC 8th edition, which showed the highest c-index and lowest AIC, BIC, and Brier score, was identified as the best among the models used.
Conclusion:
AJCC/UICC 8th edition predicted patient outcome more accurately than the other staging systems.