A comparison of prognostic classification systems for differentiated thyroid carcinoma.
OBJECTIVE
To identify and compare prognostic classification systems based on basic tumour characteristics that were developed and/or validated for differentiated thyroid carcinoma (DTC).


METHODS
Retrospective chart study.


METHODS
Literature was studied using PubMed. Fifteen different prognostic classification systems were identified, of which seven were developed or validated for DTC patients and were based on basic tumour characteristics. These systems were applied to 1225 DTC patients who were treated in our hospital between 1978 and 2002.


RESULTS
Log-rank analysis of Kaplan-Meier cancer-specific survival curves showed that the curve of the Tumor, Lymph-Node, Metastasis (TNM) system had the greatest discriminatory power (log-rank test, log P = -84.9). Cox-regression analysis showed that the TNM system was the most powerful determinant of cancer-specific survival curves. Proportion of variance explained (PVE) analysis showed that the TNM system had the highest PVE.


CONCLUSIONS
Of the prognostic classification systems analysed in this study, the TNM system performs best in all the three analyses, and is therefore the most suitable for predicting outcome in DTC-patients.
University of Würzburg, Department of Nuclear Medicine, Würzburg, Germany. verburg_e@klinik.uni-wuerzburg.de
Frederik A
FA
Verburg
Uwe
U
Mäder
Cas L J J
CL
Kruitwagen
Markus
M
Luster
Christoph
C
Reiners
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000145:classification* / Q000175:diagnosis* / Q000473:pathology; D002454:Cell Differentiation; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003940:Diagnostic Techniques, Endocrine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013964:Thyroid Neoplasms / Q000145:classification* / Q000175:diagnosis* / Q000473:pathology; D054928:Validation Studies as Topic; D055815:Young Adult