title: Identification of a cut-off for the MACIS score to predict the prognosis of differentiated thyroid carcinoma in children and young adults.
abstract: BACKGROUND
  The metastases, age at diagnosis, completeness of resection, invasion, size of the tumor (MACIS) scoring system was developed to predict disease-specific survival in patients with differentiated thyroid carcinoma (DTC), mainly for adults, with a cut-off score of 6. The purpose of this study was to evaluate its ability to predict prognosis of DTC in children and young adults.
  
  
  METHODS
  The medical records of 66 children and young adult (<21 years old) patients with DTC were reviewed retrospectively. Receiver operating characteristic (ROC) analysis was performed to determine the cut-off for predicting poor prognosis.
  
  
  RESULTS
  Extrathyroidal invasion and regional lymph node metastasis were noted in 64% each, and distant metastases were found in 8%. The optimal cut-off for the MACIS score for poor prognosis was 4 (93% sensitivity, 67% specificity). The overall 10-year recurrence-free survival was better in patients with MACIS score <4 than score ≥4 (p < .05).
  
  
  CONCLUSIONS
  A MACIS score of more than 4 was associated with a poor prognosis in children and young adult patients with DTC.
authors: Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Hye Won
authors: HW
authors: Jang
authors: Ji In
authors: JI
authors: Lee
authors: Hee Kyung
authors: HK
authors: Kim
authors: Young Lyun
authors: YL
authors: Oh
authors: Yoon-La
authors: YL
authors: Choi
authors: Dong-Kyu
authors: DK
authors: Jin
authors: Jung-Han
authors: JH
authors: Kim
authors: Jae Hoon
authors: JH
authors: Chung
authors: Sun Wook
authors: SW
authors: Kim
mesh_terms: D000293:Adolescent; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013964:Thyroid Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D055815:Young Adult
chemical_list: D007457:Iodine Radioisotopes