An evaluation of prognostic scoring systems in patients with follicular thyroid cancer

Background: Prognostic scoring systems for thyroid cancer have not been investigated in patients with pure follicular cancer; thus, the purpose of this study was to compare the following prognostic indices: the European Organization for Research and Treatment of Cancer (EORTC) method; the Age, Grade, Extent, Size (AGES) score; and the Age, Metastasis, Extent, Size (AMES) score. Patients and methods: A retrospective study reviewing 122 patients actively treated between 1955 and 1990 was conducted. Scoring systems were calculated and survival analysis completed. AGES low-risk patients were analyzed with respect to known risk factors. Results: The AGES scoring system significantly defined low- and high-risk groups (P = .0041); the ratio of deaths between high-versus low-risk groups was 1.9:1. EORTC scores distinguished four risk groups (P = 0.002). The AMES scoring system did not significantly assign risk. In multivariate analysis of low-risk AGES patients, age, perithyroidal tissue involvement, and positive frozen section reached statistical significance. Conclusions: The AGES and EORTC scoring systems best defined low- and high-risk groups of patients with pure follicular cancer, although the separation between groups was low.