Evidence map›Paper›PMID 40904805›Full record

ArticleFrontiers in endocrinology2025

Development of a new TNM staging system for poorly differentiated thyroid carcinoma: a multicenter cohort study.

Yu Guo, Qianyi Zhong, Liangen Xie, Xudong Wang, Liang Guo, Shimin Zhuang, Chunyan Jia, Lijiao Wu, Jin Peng, Feng Pang and 2 more

Abstract readMulticenter Study
In one paragraph

Article in Frontiers in endocrinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

12 authors.

Yu Guo *Department of General Surgery (Thyroid Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Qianyi Zhong *The First Clinical Medical College of Jinan University, Guangzhou, Guangdong, China.
Liangen Xie *Department of General Surgery (Thyroid Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Xudong Wang *Department of Maxillofacial and Otorhinolaryngological Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Key Laboratory of Basic and Translational Medicine on Head & Neck Cancer, Tianjin, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin, China.
Liang Guo *Department of Head and Neck Surgery, Institute of Cancer Research and Basic Medical Sciences of Chinese Academy of Sciences, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China.
Shimin ZhuangDepartment of General Surgery (Thyroid Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Chunyan JiaDepartment of Thyroid Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Lijiao WuDepartment of Otolaryngology Head and Neck (Thyroid) Surgery, Shenshan Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, China.
Jin PengDepartment of Otolaryngology Head and Neck (Thyroid) Surgery, Shenshan Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, China.
Feng PangDepartment of General Surgery (Thyroid Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Ankui YangDepartment of Head and Neck Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.
Tianrun LiuDepartment of General Surgery (Thyroid Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Poorly differentiated thyroid cancer (PDTC) is a rare, heterogeneous carcinoma from follicular cells, characterized by poor differentiation, aggressive spread, and poor prognosis. Currently, there is no specific staging system for PDTC. This study aimed to develop a new TNM staging system tailored to PDTC for improved disease management. Methods: A new TNM staging system was designed and internally validated using data from the US SEER database (2004-2016) on PDTC cases. External validation was performed using data from four major institutions in China. Prognostic factors influencing cancer-specific survival (CSS) were identified through Cox regression analyses. Patients were stratified into subgroups based on adjusted hazard ratios (AHRs), weighted by these prognostic factors. The new system classified patients into five stages with distinct 5-year CSS outcomes. Results: The study analyzed 1,201 PDTC cases from SEER and 85 cases from China. Among the 876 patients in the training cohort, the new TNM staging system showed superior discrimination compared to the 8th edition of the AJCC TNM system. The 5-year CSS rates for the new stages I, II, III, IVA, and IVB were 96.3%, 88.4%, 69.4%, 43.3%, and 22.3%, respectively. The new system outperformed the 8th edition in predicting CSS, as shown by time-dependent ROC curves, C-index, and calibration plots. Both internal and external validation confirmed its predictive abilities. Conclusion: The current AJCC staging system inadequately predicts PDTC prognosis. The new TNM staging system developed in this study offers improved stratification and prognosis prediction, potentially guiding more effective clinical management for PDTC.

Indexed as

Neoplasm StagingThyroid NeoplasmsAdultAgedCell DifferentiationChinaCohort StudiesFemaleHumansMaleMiddle AgedPrognosisSEER ProgramUnited StatesYoung Adultadjusted hazard ratiocancer-specific survivalnew TNM stagepoorly differentiated thyroid cancerprognosis prediction

Identifiers

PMID40904805
PMCPMC12401677

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.