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

Head Neck. 2012 May;34(5):696-701. doi: 10.1002/hed.21808. Epub 2011 Jul 11.

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.

MeSH terms

  • Adolescent
  • Carcinoma / mortality*
  • Carcinoma / pathology
  • Carcinoma / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Iodine Radioisotopes / therapeutic use
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local
  • Neoplasm Staging
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Sensitivity and Specificity
  • Severity of Illness Index*
  • Thyroid Neoplasms / mortality*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / therapy
  • Young Adult

Substances

  • Iodine Radioisotopes