Korean J Endocr Surg.  2015 Dec;15(4):86-92. 10.16956/kaes.2015.15.4.86.

Prediction of Nodal Metastasis by the AMES Scoring System in Patients with Papillary Thyroid Cancer

• Lee YJ
• Kim JR

• KMID: 2308575
• DOI: http://doi.org/10.16956/kaes.2015.15.4.86

Abstract

PURPOSE
We assessed the prognostic value of AMES to determine the extent of surgery in PTC patients, and compared AMES score usefulness and accuracy with [18F] FDG PET/CT.
METHODS
We conducted a review of data from a single center and a single surgeon, who treated 341 patients with PTC with total thyroidectomy and prophylactic bilateral CLN dissection at a tertiary referral center, Chungnam National University Hospital, between 2001 and 2012.
RESULTS
In multivariate analysis, the rate of CLN metastasis was considerably higher in PTC patients with the higher AMES score (odds ratio [OR], 1.718; 95% confidence interval [CI], 1.073~2.752), higher SUV of the CLN (>0) (OR, 6.525; CI, 3.184~13.371), higher SUV of the tumor (>4.3) (OR, 1.855; CI, 1.065~3.231).
CONCLUSION
The AMES score is helpful in deciding whether to perform a CLN dissection, as there is a strong association between the AMES score and CLN metastasis. This high predictive value of CLN metastasis can help determine the extent of PTC surgery while considering the cost and effort.

Keyword

Papillary thyroid carcinoma; Central lymph node; AMES; Lymph node metastasis; Positron emission tomography-computed tomography

MeSH Terms

Chungcheongnam-do
Humans
Multivariate Analysis
Neoplasm Metastasis*
Positron-Emission Tomography and Computed Tomography
Tertiary Care Centers
Thyroid Gland*
Thyroid Neoplasms*
Thyroidectomy

Figure

• 

  Fig. 1. Receiver operating characteristic curve of tumor SUVmax. With an SUVmax cutoff value of above 4.3, the surgeon can predict central lymph node (CLN) metastasis, and proceed total thyroidectomy and CLN dissection.

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  Fig. 2. Receiver operating characteristic curve of SUVmax. With an SUVmax cutoff value of above 0, the surgeon can predict central lymph node (CLN) metastasis, and proceed total thyroidectomy and CLN dissection.

Reference

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