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Article

A Three-Domain Scoring System to Customize the Risk of Relapse of Differentiated Thyroid Carcinoma

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Department of Nuclear Medicine, E.O. “Ospedali Galliera”, 16128 Genoa, Italy
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Scientific Directorate, Galliera Hospital, 16128 Genoa, Italy
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Clinical & Epidemiological Research Unit, University Hospital of Parma, 43126 Parma, Italy
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Department of Surgery, E.O. “Ospedali Galliera”, 16128 Genoa, Italy
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Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, Buenos Aires C1053, Argentina
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Servizio di Endocrinologia e Diabetologia, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), 6900 Lugano, Switzerland
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Facultà di Scienze Biomediche, Università della Svizzera Italiana (USI), 6900 Lugano, Switzerland
*
Authors to whom correspondence should be addressed.
Academic Editor: Vincenzo Marotta
Cancers 2021, 13(17), 4335; https://doi.org/10.3390/cancers13174335
Received: 23 July 2021 / Revised: 23 August 2021 / Accepted: 24 August 2021 / Published: 27 August 2021
(This article belongs to the Special Issue Thyroid Cancers)
In this study, we have identified and validated a large series of patients affected by DTC, and created a three-domain scoring system able to identify the risk of persistence-relapse of disease after initial treatment (e.g., thyroidectomy and RAI). This three-domain system includes potential prognostic factors such as demographic (age and gender) and RAI-related (pre-RAI Tg levels and the post-therapeutic 131I WBS) data. This score is easy to calculate and interpret, as it provides a score ranging from 0 to 100; it allows clinicians to identify those patients who need stricter clinical surveillance or proper treatment due to a risk of disease persistence/relapse. This prognostic system can be used to semi-quantify the recurrence risk.
Purpose: the validation of a new scoring model considering the principal risk factors of differentiated thyroid cancer (DTC) relapse. Methods: we evaluated all DTC patients treated with thyroidectomy and radioactive iodine (RAI) therapy. Three domains were considered: the demographic domain (age and gender), the surgical domain (histology and the American Thyroid Association risk categories), and the RAI-related domain (pre-RAI thyroglobulin and post-therapeutic 131I whole-body scan). The progression-free survival was assessed. The patients’ sample was randomly split into a training and validation set. The three-domain score was calculated as the weighted sum of the levels of each significant factor, then scaled to an integer range (0–100) and, finally, stratified into terciles: mild risk 0–33, moderate risk 34–66, and severe risk 67–100. Results: 907 DTC patients were included. The RAI-related domain was the most relevant factor in the score calculation. The tercile stratification identified significantly different survival curves: patients within the two upper terciles showed approximately 6 to 30 times more progressive risk than patients at mild risk. Conclusion: we have validated a three-domain scoring system and the principal impact on this score is provided by the peri-RAI findings, whose prognostic role seems to be essential in risk identification. View Full-Text
Keywords: domains; scoring system; DTC; RAI; pre-RAI Tg; post-therapeutic 131-I-WBS domains; scoring system; DTC; RAI; pre-RAI Tg; post-therapeutic 131-I-WBS
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MDPI and ACS Style

Piccardo, A.; Siri, G.; Ugolini, M.; Fiz, F.; Puntoni, M.; Bottoni, G.; Catrambone, U.; Pitoia, F.; Trimboli, P. A Three-Domain Scoring System to Customize the Risk of Relapse of Differentiated Thyroid Carcinoma. Cancers 2021, 13, 4335. https://doi.org/10.3390/cancers13174335

AMA Style

Piccardo A, Siri G, Ugolini M, Fiz F, Puntoni M, Bottoni G, Catrambone U, Pitoia F, Trimboli P. A Three-Domain Scoring System to Customize the Risk of Relapse of Differentiated Thyroid Carcinoma. Cancers. 2021; 13(17):4335. https://doi.org/10.3390/cancers13174335

Chicago/Turabian Style

Piccardo, Arnoldo, Giacomo Siri, Martina Ugolini, Francesco Fiz, Matteo Puntoni, Gianluca Bottoni, Ugo Catrambone, Fabián Pitoia, and Pierpaolo Trimboli. 2021. "A Three-Domain Scoring System to Customize the Risk of Relapse of Differentiated Thyroid Carcinoma" Cancers 13, no. 17: 4335. https://doi.org/10.3390/cancers13174335

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