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Updated: May 8, 2026
Spontaneous Murine Model of Anaplastic Thyroid Cancer
Published on: February 3, 2023
MeSS: A novel prognostic scale specific for pediatric well-differentiated thyroid cancer: a population-based, SEER
Brian J Shayota1, Shonali C Pawar, Ronald S Chamberlain
1Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ 07039, USA.
Insights
Adult prognostic systems for well-differentiated thyroid cancer (WDTC) are not reliable for children. A new MeSS (metastasis, tumor size, sex) scale better predicts outcomes in pediatric WDTC patients, identifying high-risk individuals for improved survival.
Area of Science:
- Pediatric Oncology
- Cancer Prognostics
- Thyroid Cancer Research
Background:
- Prognostic factors for adult well-differentiated thyroid cancer (WDTC) are established, but not for pediatric patients.
- Existing adult prognostic systems may not accurately predict outcomes in children with WDTC.
- Need for a pediatric-specific prognostic tool for WDTC.
Purpose of the Study:
- Evaluate the applicability of adult prognostic systems to pediatric WDTC.
- Develop and validate a novel prognostic scale for pediatric WDTC patients.
- Improve risk stratification and outcome prediction in young WDTC patients.
Main Methods:
- Utilized the Surveillance, Epidemiology, and End Results (SEER) database (1973-2009).
- Analyzed data from 895 pediatric WDTC patients (<20 years).
- Extracted data on age, gender, race, histology, tumor size, stage, and mortality; analyzed using SAS 9.2.
Main Results:
- Overall cause-specific mortality in pediatric WDTC was 0.8%.
- Distant metastasis, larger primary tumor size, and male gender were associated with worse prognosis (P < .05).
- The MeSS (metastasis, size, sex) algorithm stratified mortality risk: 0% (low), 2.7% (moderate), and 23% (high).
Conclusions:
- Adult prognostic indices for WDTC are unreliable in pediatric populations.
- The MeSS scale demonstrates applicability and improved prediction for pediatric WDTC.
- High MeSS scores significantly correlate with worse overall survival in pediatric WDTC patients.
Background:
High-risk prognostic factors for adults with well-differentiated thyroid cancer (WDTC) have been well established, but the same is not true for pediatric patients. This study sought to determine whether validated adult prognostic systems are applicable to pediatric patients and to develop a novel prognostic scale that may better reflect outcomes in pediatric subgroups.
Methods:
We queried 62,007 cases of WDTC from the Surveillance, Epidemiology, and End Results (SEER) database (1973-2009) to identify 895 patients <20 years of age with WDTC. Data abstracted included age, gender, race, histology type, primary tumor size, cancer stage, and mortality. Odds ratio and 95% confidence intervals were set and data were analyzed with SAS version 9.2.
Results:
Among 895 pediatric WDTC patients, the overall cause-specific mortality was 0.8%. The presence of distant metastasis was associated with the worst prognosis (P = .0045) followed by larger primary tumor size (P = .0135) and male gender (P = .0162). When classified into low-, moderate-, and high-risk categories according to the distant metastasis (Me), larger primary tumor size (S), and male sex (S) (MeSS) algorithm, mortality rates were 0%, 2.7%, and 23%, respectively.
Conclusion:
Commonly used prognostic indices for WDTC in adults do not reliably predict poor outcomes among pediatric patients. Rather, a system based on MeSS is more applicable to pediatric patients. Patients who exhibit a high MeSS score have a significantly worse overall survival than those who do not express any MeSS characteristics.
