Multiparameter scoring system for the prognosis of differentiated thyroid cancer

Summary The aim of the study was to develop a scoring system consisting of multiple parameters that are significant for prognosis of thyroid cancer. The score was designed to permit a risk stratification with all available information at any time of presentation. Patients, methods: A score using 25 parameters was used for 171 patients with differentiated thyroid cancer, who were included in follow up over a mean of 9 (± 5) years. The significance of each parameter as well as of a summation outcome score was determined. The result of this scoring system was compared to other scores reported in the literature applied to the same patients' group. Thirty-two out of the 171 patients presented with recurrence during follow up. Results: The summation score was highly significant for prognosis of differentiated thyroid cancer. Out of 25 parameters, 18 showed a significant association with outcome also as individual parameters. In comparison to the scores commonly used, this new system showed the highest significance (p < 0.0001, chi square 90, df 1) to estimate recurrence free survival. At a cutoff of –5.95 the sensitivity and specificity for the distinction between high and low risk patients were 87.5 and 77.0%, respectively. Conclusion: With our multiparameter scoring system a reliable prognosis with respect to recurrence free survival is possible in patients suffering from differentiated thyroid cancer. A summation score of all parameters gives the best results. Scoring is also possible, if several important parameters are missing.