Durán Poveda, Manuel1; Guadarrama González, F. Javier2; Ferrero Herrero, Eduardo2;
1 Department of Surgery, Juan Carlos I Hospital, Móstoles, Madrid, Spain
2 Department of Surgery, 12 de Octubre University Hospital, Madrid, Spain
Background: Many risk factors have been identified in differentiated thyroid cancer; with these in mind, some prognostic scores have been designed to assess risk of recurrence and survival.
Objective: To evaluate usefulness of different methods of risk assignment in differentiated thyroid cancer in surgical patients
Material and Methods: Retrospective review of 232 patients with differentiated thyroid cancer treated in our hospital from 1991 to 2014, staged by pTNM (7th edition, 2010) and followed for 1 to 23 years. Risk groups were assigned by MACIS, AGES, AMES and ATA systems. Correlation of recurrences and survival was carried out according to score or risk assignment. Curves were calculated for disease-free interval, mortality, related and not related to the thyroid tumor, age, sex, histological type, grading, Kaplan-Meyer actuarial survival, statistical significance and Wilcoxon test for comparison of pathological data.
Results: Overall survival was 96%, 93% and 84% at 5, 10 and 20 years, and a median disease-free survival of 18,5 years (range 1-20 years) with a mean survival of 16,019 years. Total mortality was 6.46% and tumor-related mortality 2.58 %. In multivariate analysis, the variables related to prognosis with respect to overall survival were: tumor size> 4 cm., Tall-cell histologic type, tumor grade, lymph node involvement, and soft tissue and vascular invasion.
Conclusion: MACIS, AGES and AMES systems are useful for risk assessment in our population, but it is necessary to become familiar with its use to select the extent of therapy in each case.
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