Evidence map›Paper›PMID 41038186›Full record

ArticleThe Lancet. Oncology2025

Genetic modification of the AJCC classification of papillary thyroid cancer: an international, multicentre, retrospective cohort study.

Mingzhao Xing, Shuhuang Lin, Aarti Mathur, Ying Li, Bela Bendlova, Vlasta Kuklikova, Miguel Melo, Tito Teles Jesus, Paula Soares, Carla Colombo and 17 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

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  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

27 authors.

Mingzhao XingDepartment of Pharmacology, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China; Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: mxing1@jhmi.edu.
Shuhuang LinDepartment of Pharmacology, School of Medicine, Southern University of Science and Technology, Shenzhen, Guangdong, China.
Aarti MathurSection of Endocrine Surgery, Division of Surgical Oncology, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ying LiDepartment of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea.
Bela BendlovaDepartment of Molecular Endocrinology, Institute of Endocrinology, Prague, Czech Republic.
Vlasta KuklikovaDepartment of Molecular Endocrinology, Institute of Endocrinology, Prague, Czech Republic.
Miguel MeloDepartment of Endocrinology, Diabetes and Metabolism, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Cancer Signalling & Metabolism, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto and Instituto de Patologia e Imunologia Molecular da Universidade do Porto (Ipatimup), Porto, Portugal.
Tito Teles JesusCancer Signalling & Metabolism, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto and Instituto de Patologia e Imunologia Molecular da Universidade do Porto (Ipatimup), Porto, Portugal.
Paula SoaresCancer Signalling & Metabolism, Instituto de Investigação e Inovação em Saúde (i3S), Universidade do Porto and Instituto de Patologia e Imunologia Molecular da Universidade do Porto (Ipatimup), Porto, Portugal; Faculty of Medicine, the University of Porto, Porto, Portugal.
Carla ColomboEndocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Laura FugazzolaEndocrine Oncology Unit, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Norisato MitsutakeDepartment of Molecular Oncology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
Michiko MatsuseDepartment of Molecular Oncology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
Ayaka SakoDepartment of Molecular Oncology, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan.
Ana Patricia Estrada-FlorezThe Health Equity Leadership, Science, and Community Research Laboratory, Genome Center, University of California, Davis, CA, USA; Grupo de Citogenética, Filogenia y Evolución de Poblaciones, Facultades de Ciencias y Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Colombia.
Luis G Carvajal-CarmonaThe Health Equity Leadership, Science, and Community Research Laboratory, Genome Center, University of California, Davis, CA, USA; Department of Biochemistry and Molecular Medicine, School of Medicine, University of California, Davis, CA, USA.
Mabel E BohórquezGrupo de Citogenética, Filogenia y Evolución de Poblaciones, Facultades de Ciencias y Facultad de Ciencias de la Salud, Universidad del Tolima, Ibagué, Colombia.
Caterina MianEndocrinology Unit, Department of Medicine (DIMED), University of Padua, Padua, Italy.
Federica VianelloDepartment of Radiotherapy, Istituto Oncologico Veneto-IRCCS, Padua, Italy.
Christine J O'NeillSurgical Services, John Hunter Hospital and University of Newcastle, Newcastle, NSW, Australia.
Roderick Clifton-BlighCancer Genetics, Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW, Australia.
Agnieszka CzarnieckaThe 3rd Department of Oncological Surgery, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland.
Barbara JarzabNuclear Medicine and Endocrine Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland.
Chan Kwon JungDepartment of Hospital Pathology, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Bayu BrahmaDepartment of Surgical Oncology, Dharmais Cancer Hospital, National Cancer Center, Jakarta, Indonesia.
Paul W LadensonDivision of Endocrinology, Diabetes and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Young Joo ParkDepartment of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea; Department of Molecular Medicine and Biopharmaceutical Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea.

Funding

Cognitive Decline and Incident Dementia in Older Patients with Secondary HyperparathyroidismR01AG076834 · NIA · JOHNS HOPKINS UNIVERSITY · PI Aarti Mathur · 2023 to 2026
$3.3M
UC Davis Multi-Disciplinary Cancer Research Training Program to Advance Precision Cancer Prevention and Care in Latin America.D43CA260869 · NCI · UNIVERSITY OF CALIFORNIA AT DAVIS · PI Luis Guillermo Carvajal Carmona, Laura Fejerman · 2022 to 2026
$1.2M
NCI NIH HHS D43 CA260869NIA NIH HHS R01 AG076834
6 · The paper itself

Abstract

backgroundThe four-stage American Joint Committee on Cancer (AJCC) staging system has been used for almost 50 years for assessing the risk of multiple cancers; the AJCC classification for papillary thyroid cancer is solely based on clinical parameters, and despite updated editions its accuracy remains suboptimal. We aimed to evaluate whether the performance of the AJCC system could be improved by integrating tumour genetic statuses of BRAF and TERT genes.

methodsThis retrospective multicentre cohort study used patient medical records from 15 medical centres across ten countries for patients (of all ages) with papillary thyroid cancer who had been surgically treated with total thyroidectomy or hemithyroidectomy with or without neck dissection, followed by postoperative radioiodine ablation and appropriate thyroid-stimulating hormone level targeting. Testing for BRAF

findingsUsing patients who were treated for papillary thyroid cancer between January 1979, to July 2023 at the 15 centres, our cohort comprised of 4746 patients (3612 [76·1%] females and 1134 [23·9%] males), with median age of 48 years (IQR 37-59; 89 [1·9%] patients aged ≤18 years). For the 4400 patients with available ethnicity data, the majority were Asian (2140 [48·6%]) and 2096 (47·6%) were White. For AJCC7E, compared with the original stages, the genetic duet of BRAF

interpretationIntegrating the genetic statuses of BRAF and TERTp into the AJCC system changes the original risk stages of the AJCC system and significantly improves the accuracy of its mortality risk classification for papillary thyroid cancer.

fundingNational Institute on Aging, the Auburn Community Cancer Endowed Chair in Basic Research, the Heart, Breast, and Brain Health Equity Research program, National Institutes of Health, and the American Association for Cancer Research Fellowship 21-40-69-ESTR (USA); Ministry of Health (Czech Republic); Prémio Francisco Augusto da Fonseca Dias e Maria José Melenas da Fonseca para Jovens Investigadores (Portugal); Italian Ministry of Health-Ricerca Corrente (Italy); JSPS KAKENHI (Japan); MINCIENCIAS, L'OREAL-UNESCO-ICETEX-COLCIENCIAS, Universidad del Tolima (Colombia); STRATEGMED2/267398/4/NCBR/2015, the National Centre for Research and Development (Poland); RISBIN IPTEKDOK 2014, Ministry of Health (Indonesia); and the Information and Communications Technology and Future Planning of the Basic Science Research Program via the National Research Foundation of Korea (NRF) funded by the Ministry of Science (Korea).

Indexed as

Proto-Oncogene Proteins B-rafTelomeraseThyroid Cancer, PapillaryThyroid NeoplasmsAdultAgedFemaleHumansMaleMiddle AgedMutationNeoplasm StagingRetrospective StudiesThyroidectomyYoung AdultBRAF protein, humanProto-Oncogene Proteins B-rafTelomeraseTERT protein, human

Identifiers

PMID41038186
PMCPMC12969324

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