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Αλέξανδρος Γ. Σφακιανάκης

Sunday, September 12, 2021

A Three-Domain Scoring System to Customize the Risk of Relapse of Differentiated Thyroid Carcinoma

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Cancers (Basel). 2021 Aug 27;13(17):4335. doi: 10.3390/cancers13174335.

ABSTRACT

PURPOSE: the validation of a new scoring model considering the principal risk factors of differentiated thyroid cancer (DTC) relapse.

METHODS: we evaluated all DTC patients treated with thyroidectomy and radioactive iodine (RAI) therapy. Three domains were considered: the demographic domain (age and gender), the surgical domain (histology and the American Thyroid Association risk categories), and the RAI-related domain (pre-RAI thyroglobulin and post-therapeutic 131I whole-body scan). The progression-free survival was assessed. The patients' sample was randomly split into a training and validation set. The three-domain score was calculated as the weighted sum of the levels of each significant factor, then scaled to an integer range (0-100) and, finally, stratified into terciles: mild risk 0-33, moderate risk 34-66, and severe risk 67-100.

RESULTS: 907 DTC patients were included. The RAI-related domain was the most relevant factor in the score calculation. The tercile stratification identified significantly different survival curves: patients within the two upper terciles showed approximately 6 to 30 times more progressive risk than patients at mild risk.

CONCLUSION: we have validated a three-domain scoring system and the principal impact on this score is provided by the peri-RAI findings, whose prognostic role seems to be essential in risk identificat ion.

PMID:34503146 | DOI:10.3390/cancers13174335

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