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2002, Number 4

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Cir Cir 2002; 70 (4)

Rational treatment of differentiated thyroid cancer by risk-group assignment

Rodríguez-Cuevas S, Labastida-Almendaro S, Cortés-Arroyo H, López-Garza J, Barroso-Bravo S

Language: Spanish
References: 22
Page: 232-238
PDF size: 49.79 Kb.


ABSTRACT

Background: Many risk factors have been identified in differentiated thyroid cancer; with these in mind, some prognostic scores have been designed to assign risk of recurrence and survival. Objective: To evaluate usefulness of three different methods of risk assignment in differentiated thyroid cancer in Mexican patients. Methods: This is a retrospective review of 180 patients with differentiated thyroid cancer completely treated from 1980 to 1990. All prognostic factors were analyzed and a score obtained either by method of AGES, MACIS, or SKMH. Correlation of recurrences and survival was carried out according to score or risk assignment. Results: According to AGES, 46% were high-risk patients, 49.4% with MACIS and 45.5% with SKMH, respectively. Median follow-up was 8.3 years. There were 67 (37%) recurrences. Ten-year overall survival was 89.4% and disease-free survival was 79.2%. Cox multivariate model showed that age above 45 years, tumor size of 5 cm or more, follicular histology, multiple macroscopic thyroid tumors, and extracapsular node invasion affected 10-year survival. Conclusions: Nearly one half of our patients belonged to the high-risk group. In Mexican population, with 50% of high-risk patients AGES and MACIS scores are useful to assign risk group. It is mandatory to be familiar with these scores to select individualized therapy adequately.


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