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Identification of a cut-off for the macis score to predict the prognosis of differentiated thyroid carcinoma in children and young adults

Authors

  • Hye Won Jang MD, PhD,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Ji In Lee MD,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Hee Kyung Kim MD,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Young Lyun Oh MD, PhD,

    1. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Yoon–La Choi MD, PhD,

    1. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Dong–Kyu Jin MD, PhD,

    1. Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Jung–Han Kim MD, PhD,

    1. Department of General Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Jae Hoon Chung MD, PhD,

    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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  • Sun Wook Kim MD, PhD

    Corresponding author
    1. Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
    • Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Abstract

Background

The metastases, age at diagnosis, completeness of resection, invasion, size of the tumor (MACIS) scoring system was developed to predict disease-specific survival in patients with differentiated thyroid carcinoma (DTC), mainly for adults, with a cut-off score of 6. The purpose of this study was to evaluate its ability to predict prognosis of DTC in children and young adults.

Methods

The medical records of 66 children and young adult (<21 years old) patients with DTC were reviewed retrospectively. Receiver operating characteristic (ROC) analysis was performed to determine the cut-off for predicting poor prognosis.

Results

Extrathyroidal invasion and regional lymph node metastasis were noted in 64% each, and distant metastases were found in 8%. The optimal cut-off for the MACIS score for poor prognosis was 4 (93% sensitivity, 67% specificity). The overall 10-year recurrence-free survival was better in patients with MACIS score <4 than score ≥4 (p < .05).

Conclusion

A MACIS score of more than 4 was associated with a poor prognosis in children and young adult patients with DTC. © 2011 Wiley Periodicals, Inc. Head Neck, 2012

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