Multiparameter scoring system for the prognosis of differentiated thyroid cancer.
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.


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.


CONCLUSIONS
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.
Welsch
M
M
Department of Nuclear Medicine, University of Frankfurt/Main, Theodor-Stern-Kai 7, 60590 Frankfurt, Germany. Michaela.Welsch@kgu.de
Abeln
M
M
Zaplatnikov
K
K
Menzel
C
C
Ackermann
H
H
Döbert
N
N
Grünwald
F
F
D002454:Cell Differentiation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012372:ROC Curve; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed