Multiparameter scoring system for the prognosis of differentiated thyroid cancer

Nuklearmedizin. 2007;46(6):257-62; quiz N53-4. doi: 10.3413/nukmed-0078.

Abstract

The AIM of the study was to develop a scoring system consisting of multiple parameters that are significant for prognosis of thyroid cancer. The score was designed to permit a risk stratification with all available information at any time of presentation.

Patients, methods: A score using 25 parameters was used for 171 patients with differentiated thyroid cancer, who were included in follow up over a mean of 9 (+/- 5) years. The significance of each parameter as well as of a summation outcome score was determined. The result of this scoring system was compared to other scores reported in the literature applied to the same patients' group. Thirty-two out of the 171 patients presented with recurrence during follow up.

Results: The summation score was highly significant for prognosis of differentiated thyroid cancer. Out of 25 parameters, 18 showed a significant association with outcome also as individual parameters. In comparison to the scores commonly used, this new system showed the highest significance (p < 0.0001, chi square 90, df 1) to estimate recurrence free survival. At a cutoff of -5.95 the sensitivity and specificity for the distinction between high and low risk patients were 87.5 and 77.0%, respectively.

Conclusion: With our multiparameter scoring system a reliable prognosis with respect to recurrence free survival is possible in patients suffering from differentiated thyroid cancer. A summation score of all parameters gives the best results. Scoring is also possible, if several important parameters are missing.

MeSH terms

  • Cell Differentiation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging*
  • Positron-Emission Tomography
  • Prognosis
  • ROC Curve
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Thyroid Neoplasms / diagnostic imaging
  • Thyroid Neoplasms / pathology*
  • Tomography, X-Ray Computed