Migration of Risk Classification Between the JAES Versus ATA guidelines for Papillary Thyroid Carcinoma

Author:

Yamazaki Haruhiko1ORCID,Masudo Katsuhiko1,Rino Yasushi2

Affiliation:

1. Department of Breast and Thyroid Surgery Yokohama City University Medical Center 4‐57 Urafunecho, Minamiku 232‐0024 Yokohama City, Kanagawa Japan

2. Department of Surgery Yokohama City University School of Medicine 3‐9 Fukuura, Kanazawa‐Ku 236‐0004 Yokohama City, Kanagawa Japan

Abstract

AbstractBackgroundThis study aimed to investigate outcomes in the same cohort of patients with papillary thyroid carcinoma (PTC) risk‐stratified according to the Japan Association of Endocrine Surgery (JAES) and American Thyroid Association (ATA) guidelines.MethodsA total of 1044 patients with PTC who underwent initial thyroidectomy at Yokohama City University Medical Center between January 2000 and June 2022 were included.ResultsAccording to the JAES guidelines, 480 (46%), 386 (37%), and 178 (17%) patients were classified as low, intermediate, or high risk, respectively. Furthermore, according to the ATA guidelines, 590 (57%), 261 (25%), and 193 (18%) patients were reclassified as low, intermediate, or high risk, respectively. Among 1044 patients with PTC, the 10‐year cause‐specific survival (CSS) rates of patients with JAES low and intermediate risk were 99.7 and 98.6%, respectively, and there was no statistically difference (p = 0.096). However, the 10‐year CSS rates of patients with ATA low and intermediate risk were 100 and 99.5%, respectively (p = 0.007). Among 1001 patients with M0 PTC, the 10‐year distant metastasis‐free survival (DMFS) rates of patients with JAES intermediate and high risk were 94.2, and 76.7%, respectively (p < 0.001). However, the 10‐year DMFS rates of patients with ATA intermediate and high risk were 88.1 and 86.6%, respectively (p = 0.233), and there was no statistically difference.ConclusionsBoth JAES and ATA risk classifications properly stratified the PTC patients. Furthermore, the ATA risk classification more precisely extracted patients with better and worse prognoses.

Publisher

Wiley

Subject

Surgery

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