| |
|
Table 3. Components of Prognostic Schemes
Used for Defining Risk-Group Categories in Patients With Follicular-Cell-Derived
Thyroid (Follicular & Papillary)
Carcinoma |
|
Prognostic
Variable
|
EORTC [7]
(1979)
|
AGES [11]
(1987)
|
AMES [14]
(1988)
|
MACIS [13]
(1993)
|
OSU [12]
(1994)
|
MSKCC [9]
(1995)
|
NTCTCS
[10]
(1998)
|
|
Patient factors
|
|
Age
|
X
|
X
|
X
|
X
|
-
|
X
|
X
|
|
Sex
|
X
|
-
|
X
|
-
|
-
|
-
|
-
|
|
Tumor factors
|
|
Size
|
-
|
X
|
X
|
X
|
X
|
X
|
X
|
|
Multicentricity
|
-
|
-
|
-
|
-
|
X
|
-
|
X
|
|
Histologic grade
|
-
|
X
|
-
|
-
|
-
|
X
|
-
|
|
Histologic type
|
X
|
Y
|
X
|
Y
|
-
|
X
|
X
|
|
Extrathyroidal invasion
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
|
Nodal metastatic lesion
|
-
|
-
|
-
|
-
|
X
|
X
|
X
|
|
Distant metastatic lesion
|
X
|
X
|
X
|
X
|
X
|
X
|
X
|
|
Operative factors
|
|
Incomplete resection
|
-
|
-
|
-
|
X
|
-
|
-
|
-
|
|
X = variable used in defining risk group
Y = schemes devised only for PTC
- = variable not used
EORTC = European Organization for Research on Treatment of Cancer
AGES = patient age, histologic grade of the tumor, tumor extent (extrathyroidal
invasion or distant metastases), and size of the primary tumor
AMES = patient age, presence of distant metastases, extent and size of the
primary tumor
MACIS = metastasis, patient age, completeness of resection, local invasion,
and tumor size (Mayo Clinic)
OSU = Ohio State University
MSKCC = Memorial Sloan-Kettering Cancer Center
NTCTCS = National Thyroid Cancer Treatment Cooperative Study
Table 4. Prognostic Scoring Systems: AGES, AMES, and MACIS |
|
AGES [11]
|
Prognostic score = 0.05 x age (if age >/= 40)
|
|
+ 1 (if grade 2)
|
|
+ 3 (if grade 3 or 4)
|
|
+ 1 (if extrathyroid)
|
|
+ 3 (if distant spread)
|
|
+ 0.2 x tumor size (cm maximum diameter)
|
|
Survival by AGES score (20-yr):
|
|
=/< 3.99 = 99%
|
|
4-4.99 = 80%
|
|
5-5.99 = 67%
|
|
>/= 6 = 13%
|
|
AMES [14]
|
Low risk:
|
Younger patients (men =/< 40, women =/< 50)
with no metastases
|
|
|
Older patients (intrathyroid papillary, minor
capsular invasion for follicular lesions)
|
|
|
Primary cancers <5 cm
|
|
|
No distant metastases
|
|
High risk:
|
All patients with distant metastases
|
|
|
Extrathyroid papillary, major capsular
invasion follicular
|
|
|
Primary cancers >/= 5 cm in older patients
(men >40, women >50)
|
|
Survival by AMES risk-groups (20-yr):
|
|
Low risk = 99%
|
|
High risk = 61%
|
|
MACIS [13]
|
Score = 3.1 (if age <40 years) or 0.08 x age (if
age >/= 40 yrs)
|
|
+ 0.3 x tumor size (cm maximum
diameter)
|
|
+ 1 (if incompletely resected)
|
|
+ 1 (if locally invasive)
|
|
+ 3 (if distant spread)
|
|
Survival by MACIS score (20-yr):
|
|
< 6 = 99%
|
|
6-6.99 = 89%
|
|
7-7.99 = 56%
|
|
>/= 8 = 24%
|
|
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