{"doi":"10.1111/cen.14482","title":"The prognostic value of lymph node metastasis and the eighth edition of AJCC for patients with anaplastic thyroid cancer","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>The eighth edition of the American Joint Committee on Cancer (AJCC‐v8) for anaplastic thyroid cancer (ATC) made a revision in staging for patients with lymph node metastasis (LNM) based on the seventh edition of AJCC (AJCC‐v7). Our study aimed to evaluate the predictive ability of AJCC‐v8 for survival in patients with ATC by exploring the association between lymph node stage and prognosis of ATC patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Retrospective study of ATC in Surveillance, Epidemiology and End Results (SEER) database. The association between LNM and survival of ATC was estimated by the Kaplan‐Meier method and Cox regression model. The predictive performances of the AJCC‐v8 and AJCC‐v7 were estimated through C‐index, Akaike information criterion (AIC) and Bayesian information criterion (BIC).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 313 patients with ATC were included in our analysis. Notably, LNM was identified as an independent risk factor for ATC mortality (adjusted HR, 1.47, 95% CI, 1.10–1.96; <jats:italic>p</jats:italic> = .009), while the risk of mortality in N1a group was comparable to that in N1b group according to univariate (HR, 1.30, 95% CI, 0.92–1.82; <jats:italic>p </jats:italic>= .133) and multivariate (adjusted HR 0.87, 95% CI, 0.60–1.27; <jats:italic>p </jats:italic>= .467) cox analyses. Applying the AJCC‐v8, the survival of migration population staged T1‐3aN1M0 was significantly worse than that of T1‐3aN0M0 patients (IVA stage), while was not different from that of T3b‐T4bN0/N1M0 patients (IVB stage). With a higher C‐index (0.60 vs. 0.59), lower AIC (2728 vs. 2732) and BIC (2732 vs. 2735), AJCC‐v8 was demonstrably a more favourable prediction model than AJCC‐v7.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>This study demonstrated that LNM was independently associated with poor prognosis of ATC, and AJCC‐v8 with the modified staging of patients with LNM showed better survival predictive performance in ATC patients than AJCC‐v7.</jats:p></jats:sec>","journal":"Clinical Endocrinology","year":2021,"id":650503,"datarank":0.4636563680037475,"base_score":3.091042453358316,"endowment":3.091042453358316,"self_citation_contribution":0.4636563680037475,"citation_network_contribution":0.0,"self_endowment_contribution":0.4636563680037475,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1696150,"name":"Yan‐Ci Zhao","orcid":null,"position":1,"is_corresponding":false},{"id":375922,"name":"Qi Wu","orcid":"0000-0002-7626-6089","position":2,"is_corresponding":false},{"id":1245950,"name":"Lijun Wang","orcid":"0000-0001-5773-3422","position":3,"is_corresponding":false},{"id":1696151,"name":"Shengrong Sun","orcid":"0000-0003-2893-6735","position":4,"is_corresponding":false},{"id":1696149,"name":"Hanpu Zhang","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"The prognostic value of lymph node metastasis and the eighth edition of AJCC for patients with anaplastic thyroid cancer","abstract":"<jats:title>Abstract</jats:title><jats:sec><jats:title>Objective</jats:title><jats:p>The eighth edition of the American Joint Committee on Cancer (AJCC‐v8) for anaplastic thyroid cancer (ATC) made a revision in staging for patients with lymph node metastasis (LNM) based on the seventh edition of AJCC (AJCC‐v7). Our study aimed to evaluate the predictive ability of AJCC‐v8 for survival in patients with ATC by exploring the association between lymph node stage and prognosis of ATC patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Retrospective study of ATC in Surveillance, Epidemiology and End Results (SEER) database. The association between LNM and survival of ATC was estimated by the Kaplan‐Meier method and Cox regression model. The predictive performances of the AJCC‐v8 and AJCC‐v7 were estimated through C‐index, Akaike information criterion (AIC) and Bayesian information criterion (BIC).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 313 patients with ATC were included in our analysis. Notably, LNM was identified as an independent risk factor for ATC mortality (adjusted HR, 1.47, 95% CI, 1.10–1.96; <jats:italic>p</jats:italic> = .009), while the risk of mortality in N1a group was comparable to that in N1b group according to univariate (HR, 1.30, 95% CI, 0.92–1.82; <jats:italic>p </jats:italic>= .133) and multivariate (adjusted HR 0.87, 95% CI, 0.60–1.27; <jats:italic>p </jats:italic>= .467) cox analyses. Applying the AJCC‐v8, the survival of migration population staged T1‐3aN1M0 was significantly worse than that of T1‐3aN0M0 patients (IVA stage), while was not different from that of T3b‐T4bN0/N1M0 patients (IVB stage). With a higher C‐index (0.60 vs. 0.59), lower AIC (2728 vs. 2732) and BIC (2732 vs. 2735), AJCC‐v8 was demonstrably a more favourable prediction model than AJCC‐v7.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>This study demonstrated that LNM was independently associated with poor prognosis of ATC, and AJCC‐v8 with the modified staging of patients with LNM showed better survival predictive performance in ATC patients than AJCC‐v7.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":3.091042453358316,"endowment":3.091042453358316,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"33864292","pmcid":"PMC8453880","openalex_id":"https://openalex.org/W3156215482","authors":[],"funders":[{"funder_name":"National Natural Science Foundation of China","grant_id":"81471781","title":null},{"funder_name":"National Major Scientific Instruments and Equipment Development Projects","grant_id":"2012YQ160203","title":null},{"funder_name":"Fundamental Research Funds for the Central Universities of China","grant_id":"2042019kf0102","title":null}],"total_grants":3,"fwci":2.9635,"citation_percentile":0.92202152,"influential_citations":0,"citation_trend":[{"year":2022,"count":2},{"year":2023,"count":16},{"year":2024,"count":3}],"oa_status":"hybrid","license":"cc-by-nc","oa_locations":[{"url":"https://doi.org/10.1111/cen.14482","host_type":"journal"},{"url":"https://doi.org/10.1111/cen.14482","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/cen.14482","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/cen.14482","host_type":"publisher"},{"url":"https://pubmed.ncbi.nlm.nih.gov/33864292","host_type":"repository"},{"url":"http://europepmc.org/pmc/articles/PMC8453880","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/8453880","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC8453880","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC8453880?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["Thyroid Cancer Diagnosis and Treatment","Thyroid and Parathyroid Surgery","Breast Cancer Treatment Studies","Bayes Theorem","Humans","Lymphatic Metastasis","Neoplasm Staging","Prognosis","Retrospective Studies","Thyroid Carcinoma, Anaplastic","Thyroid Neoplasms"],"mesh_terms":["Bayes Theorem","Humans","Lymphatic Metastasis","Neoplasm Staging","Prognosis","Retrospective Studies","Thyroid Neoplasms","Thyroid Carcinoma, Anaplastic"],"keywords":["Anaplastic thyroid cancer","Medicine","Oncology","Internal medicine","Cancer","Thyroid cancer","Lymph node metastasis","Metastasis","Thyroid","Lymph node","Cancer research","Survival","Ajcc"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T05:35:14.835897Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}