Dynamic risk stratification for predicting the recurrence in differentiated thyroid cancer.

Abstract

To analyze the predictive value of the dynamic risk stratification (DRS) system for assessing the risk of recurrent/persistent disease in our large group of differentiated thyroid carcinoma (DTC) patients. We retrospectively included 2184 consecutive patients who received radioiodine ablation therapy following a total or near total thyroidectomy in our department between 1998 and 2014. The American Thyroid Association (ATA) classification was used for initial risk classification. At the second year of follow-up period after radioiodine ablation therapy, DRS was performed also. The ATA and DRS risk classification results were compared with clinical outcome. According to DRS, more than half of the ATA high-risk patients (73.2%) moved to the DRS low-risk category and the 6.4% of ATA low-risk patients comprised the DRS high-risk category. In comparison of variables within the ATA and the DRS risk groups with clinical outcome, combined use of the ATA and the DRS systems was statistically significant to predict the recurrent/persistent disease (P<0.005). The present study revealed that the DRS system is a necessary stratification system in addition to the initial risk evaluation. The DRS can discriminate those patients who does not require closer follow-up in the long-term period.