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An evaluation of prognostic scoring systems in patients with follicular thyroid cancer
N L Davis1, S P Bugis, G I McGregor
1Department of Surgery, University of British Columbia, Vancouver Hospital and Health Sciences Center, Canada.
Background:
Prognostic scoring systems for thyroid cancer have not been investigated in patients with pure follicular cancer; thus, the purpose of this study was to compare the following prognostic indices: the European Organization for Research and Treatment of Cancer (EORTC) method; the Age, Grade, Extent, Size (AGES) score; and the Age, Metastasis, Extent, Size (ALIES) score.
Patients And Methods:
A retrospective study reviewing 122 patients actively treated between 1955 and 1990 was conducted. Scoring systems were calculated and survival analysis completed. AGES low-risk patients were analyzed with respect to known risk factors.
Results:
The AGES scoring system significantly defined low- and high-risk groups (P = 0.0041); the ratio of deaths between high-versus low-risk groups was 1.9:1. EORTC scores distinguished four risk groups (P = 0.002). The AMES scoring system did not significantly assign risk. In multivariate analysis of low-risk AGES patients, age, perithyroidal tissue involvement, and positive frozen section reached statistical significance.
Conclusions:
The AGES and EORTC scoring systems best defined low- and high-risk groups of patients with pure follicular cancer, although the separation between groups was low.