Archives of Head and Neck Surgery
Archives of Head and Neck Surgery

Impact of TNM® 8th edition on thyroid cancer retrospective staging

Oona Tomiê Daronch, Nicolas Galat Ahumada

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Introduction: Thyroid carcinoma has a global survival close to 97% in 15 years. The 8th TNM® has recently been proposed, with changes that include an increase in the cut-off age from 45 to 55 years, a change in the role of microscopic extra-thyroidal tumor invasion (which is no longer considered a criterion for the classification of T3 tumors), and the presence of cervical metastases as a criterion for staging. As a result, a large proportion of patients are transferred to earlier stages. Methods: Retrospective descriptive cross-sectional study carried out through analysis of the medical records of patients undergoing thyroidectomy at HC-UFPR from January 2014 to December 2017. Inclusion criteria were patients with a postoperative pathological anatomic diagnosis of well-differentiated thyroid carcinoma (DTC) who underwent primary surgery in the study period. Results: 197 patients underwent thyroidectomy during the period considered, 58 with thyroid neoplasia and 34 with DTC. Eight patients had lymph node metastasis, five (14.70%) as N1a and three (8.83%) as N1b. Of the total sample, six (12.5%) patients presented downstaging from the 7th to the 8th edition of the TNM®. One of the re-staged patients had bone metastasis during follow-up and died during surgery to correct a pathological fracture. Conclusion: In this study sample, the update of the TNM® in its 8th edition resulted in the downstaging of six (12.5%) patients with DTC. A longer follow-up and a larger sample are necessary to correctly assess the impact of this change on patient prognosis.


thyroid diseases; thyroidectomy; neoplasm staging


1. La Vecchia C, Malvezzi M, Bosetti C, Garavello W, Bertuccio P, Levi F, Negri E. Thyroid cancer mortality and incidence: a global overview. Int J Cancer. 2015;136(9):2187-95. PMid:25284703.

2. Casella C, Ministrini S, Galani A, Mastriale F, Cappelli C, Portolani N. The new TNM staging system for thyroid cancer and the risk of disease downstaging. Front Endocrinol (Lausanne). 2018;9:541. PMid:30279679.

3. Rosário PW, Barroso AL, Padrão EL, Rezende LL, Purisch S. Estadiamento do carcinoma diferenciado de tireóide pela classificação AJCC/TNM. Arq Bras Endocrinol Metabol. 2004;48(4):575-6. PMid:15761524.

4. Davies L, Welch HG. Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014;140(4):317-22. jamaoto.2014.1. PMid:24557566.

5. Kim YN, Kim M, Ahn HS, Kim K, Park SY, Kim HI, Jeon MJ, Kim WG, Kim SW, Kim WB, Chung JH, Shong YK, Kim TY, Kim TH. Refining the tumor-node-metastasis staging system for individualized treatment of differentiated thyroid carcinoma. Oral Oncol. 2019;89:8-13. PMid:30732964.

6. Kim M, Kim WG, Oh H-S, Park S, Kwon H, Song DE, Kim TY, Shong YK, Kim WB, Sung T-Y, Jeon MJ. Diagnosis and treatment of low-risk papillary thyroid microcarcinoma. Korean Med Assoc. 2018;61(4):232-240.

7. Hulse K, Williamson A, Gibb FW, Conn B, Nixon IJ. Evaluating the predicted impact of changes to the AJCC/TMN staging system for differentiated thyroid cancer (DTC): a prospective observational study of patients in South East Scotland. Clin Otolaryngol. 2019;44(3):330-5. PMid:30720920.

8. Verburg FA, Mäder U, Luster M, Reiners C. The effects of the Union for International CancerControl/American Joint Committee on Cancer Tumour, Node, Metastasis system version 8 on staging of differentiated thyroid cancer: a comparison to version 7. Clin Endocrinol (Oxf). 2018;88(6):950-6. http://dx.doi. org/10.1111/cen.13597. PMid:29573277.

9. van Velsen EFS, Stegenga MT, van Kemenade FJ, Kam BLR, van Ginhoven TM, Visser WE, Peeters RP. Comparing the Prognostic Value of the Eighth Edition of the American Joint Committee on Cancer/Tumor Node Metastasis Staging System Between Papillary and Follicular Thyroid Cancer. Thyroid. 2018;28(8):976-81. PMid:29848239.

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