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Gulhane Med J. 2014; 56(3): 138-142

The effect of scoring systems for predicting locoregional recurrence in patients with differentiated thyroid cancer

Bekir Ozdemir, Zafer Kılbaş, Taner Yiğit, Orhan Kozak, Mustafa Öner Menteş, İsmail Arslan.

Differentiated thyroid cancer constitutes approximately 90% of all thyroid tumors. Despite the excellent prognosis in the majority of patients, recurrence rates remain high. Although many scoring systems (TNM, AMES, MACIS etc) have been described to predict the prognosis, there is lack of scoring systems related to recurrence. We aimed to analyse the effect of scoring systems in predicting the recurrences rates. We retrospectively reviewed 106 patients with differentiated thyroid cancer. The patients were divided into risk groups, based on MACIS and MSKCC scoring system. The predictive value of the scoring system for assessing the recurrence rates were calculated. The rate of papillary, folicular and hurthle cell cancer were 82%, 10.4 % and 7.6% respectively. During a 35-month follow-up period, 16 patients were diagnosed with the locoregional recurrence. With MACIS scoring sytems, the locoregional recurrence rates were 9.1%, 42.9%, 50% and 42.9% for stage I, II, III and IV respectively. MSKCC calculated the recurrence risks as 4%, 20.9% and 38.5 for low, median and high risk, respectively. The most important factors for locoregionel recurrence were tumor size and extracapsular invasion. Scoring systems may be helpful in predicting locoregional recurrence and thus patients who will benefit from adjuvant therapy can be determined.

Key words: Differentiated thyroid cancer, MACIS, prognostic factors, scoring systems

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