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        Thyroid Cancer MACIS Prognostic Scoring
      
Table 3. Components of Prognostic Schemes Used for Defining Risk-Group Categories in Patients With Follicular-Cell-Derived Thyroid (Follicular & Papillary) Carcinoma

Prognostic Variable

EORTC [7]
(1979)

AGES [11]
(1987)

AMES [14]
(1988)

MACIS [13]
(1993)

OSU [12]
(1994)

MSKCC [9]
(1995)

NTCTCS [10]
(1998)

Patient factors

Age

X

X

X

X

-

X

X

Sex

X

-

X

-

-

-

-

Tumor factors

Size

-

X

X

X

X

X

X

Multicentricity

-

-

-

-

X

-

X

Histologic grade

-

X

-

-

-

X

-

Histologic type

X

Y

X

Y

-

X

X

Extrathyroidal invasion

X

X

X

X

X

X

X

Nodal metastatic lesion

-

-

-

-

X

X

X

Distant metastatic lesion

X

X

X

X

X

X

X

Operative factors

Incomplete resection

-

-

-

X

-

-

-

X = variable used in defining risk group
Y = schemes devised only for PTC
- = variable not used
EORTC = European Organization for Research on Treatment of Cancer
AGES = patient age, histologic grade of the tumor, tumor extent (extrathyroidal invasion or distant metastases), and size of the primary tumor
AMES = patient age, presence of distant metastases, extent and size of the primary tumor
MACIS = metastasis, patient age, completeness of resection, local invasion, and tumor size (Mayo Clinic)
OSU = Ohio State University
MSKCC = Memorial Sloan-Kettering Cancer Center
NTCTCS = National Thyroid Cancer Treatment Cooperative Study

Table 4. Prognostic Scoring Systems: AGES, AMES, and MACIS

AGES [11]

Prognostic score = 0.05 x age (if age >/= 40)

+ 1 (if grade 2)

+ 3 (if grade 3 or 4)

+ 1 (if extrathyroid)

+ 3 (if distant spread)

+ 0.2 x tumor size (cm maximum diameter)

Survival by AGES score (20-yr):

=/< 3.99 = 99%

4-4.99 = 80%

5-5.99 = 67%

>/= 6 = 13%

AMES [14]

Low risk:

Younger patients (men =/< 40, women =/< 50)
with no metastases

 

Older patients (intrathyroid papillary, minor
capsular invasion for follicular lesions)

 

Primary cancers <5 cm

 

No distant metastases

High risk:

All patients with distant metastases

 

Extrathyroid papillary, major capsular
invasion follicular

 

Primary cancers >/= 5 cm in older patients
(men >40, women >50)

Survival by AMES risk-groups (20-yr):

   Low risk = 99%

   High risk = 61%

MACIS [13]

Score = 3.1 (if age <40 years) or 0.08 x age (if age >/= 40 yrs)

   + 0.3 x tumor size (cm maximum diameter)

   + 1 (if incompletely resected)

   + 1 (if locally invasive)

   + 3 (if distant spread)

Survival by MACIS score (20-yr):

   < 6 = 99%

   6-6.99 = 89%

   7-7.99 = 56%

   >/= 8 = 24%

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