Predictive value of AMES scoring system in selection of extent of surgery in well differentiated carcinoma of thyroid.
The extent of surgical resection continues to be controversial for treatment of well-differentiated thyroid carcinoma (WDTC). It has been proposed that age, distant metastases, extent, and size (AMES) are prognostic indicators for WDTC. In this retrospective study, the role of AMES in selection and extent of surgical resection was evaluated. A total of 155 patients with WDTC treated between 1970 and 1990 at this institution were reviewed. The mean follow-up was 9 years. Patients were divided into low risk (Group A), and high risk (Group B) based on AMES. Group A had 141 patients, and Group B had 14 patients. Ninety-eight patients underwent total or subtotal thyroidectomy; 87 of these were in Group A and 11 in Group B. Fifty-seven patients had lesser surgical resection (53 lobectomy and isthmusectomy, three excision of nodule, and one needle biopsy). Five of the 11 in Group B who had more extensive surgery and none of 3 who had lesser surgery have died of their disease. Three patients in Group A have died of WDTC, of which two had total thyroidectomy and one had lobectomy with isthmusectomy. This study suggests that conservative resection is an adequate treatment in low risk patients based on AMES. This treatment may be enough for high risk patients, although the number of patients is small to make definitive recommendations.
Methodist Hospital of Memphis, Tennessee.
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Van Nguyen
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Dilawari
D018263:Adenocarcinoma, Follicular / Q000145:classification* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002291:Carcinoma, Papillary / Q000145:classification* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012306:Risk; D015996:Survival Rate; D013964:Thyroid Neoplasms / Q000145:classification* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D013965:Thyroidectomy / Q000379:methods*