Abstract
For the purpose of predicting postoperative local recurrence and/or distant metastasis in differentiated thyroid cancer, a discriminant analysis was done. To assess the reliability of this method and the induced function, simulation was done by using random samples under various conditions. Simulation revealed that the results obtained by this method were relatively stable. The discriminant functions Z1 and Z2 were induced, which are required at many hospitals. If the ratio of recurrence is less than 1:8 in a hospital, function Z1 should be applied. If the ratio is 1:10, function Z2 should be applied.
Z1=−(sex×2.104)+(age×0.032) −(diameter of tumor×0.033) −(site of tumor×0.871)−(histology×0.393) +0.249 (discriminant boundary 0.451)
Z2=−(sex×1.967)+(age×0.018)+(diameter of tumor ×0.025)−(site of tumor×0.646) +(histology×0.014)−(local invasion×0.840) −(lymph node metastasis×0.009) +(operation×0.364) −(lymph node dissection×0.235) +1.058 (discriminant boundary 0.400)
In an internal check, sensitivity was 78%, specificity 64%, and false-negative rate 5%. In an external check, sensitivity was 68%, specificity 93%, and false-negative rate 9%. In the actual application to hospitals, sensitivity was 58% to 100%, specificity 47% to 63%, and false-negative rate 0% to 16%. In clinical usage, a high sensitivity and low false-negative rate are required. These results fulfilled this condition.
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References
Crile G Jr (1971) Changing and results in patients with papillary carcinoma of the thyroid. Surg Gynecol Obstet 132:460–468
Cady B, Sedgwick CE, Meissner WA, Bookwalter JR, Romagosa V, Werber J (1976) Changing clinical pathologic therapeutic and survival patterns in differentiated thyroid carcinima. Ann Surg 184:541–552
Franssila KO (1975) Prognosis in thyroid carcinoma. Cancer 36:1138–1146
Franssila KO (1973) Is the differentiation between papillary and follicular thyroid carcinoma valid? Cancer 32:853–864
Mazzaferri EL, Young RL, Oertel JE, Kemmerer WT, Page CP (1977) Papillary thyroid carcinoma: The impact of therapy in 576 patients. Medicine (Baltimore) 56:171–196
Gardet P, Parmentier C, Gerard-Marchant R, L'Heritier C, Caillou B, Cukersztein W, Tubiana M (1977) Differentiated cancers of the thyroid: Course after treatment with special reference to frequency and chronology of the first relapse for 470 treated patients. Ann Radiol (Paris) 20:831–840
Russell MA, Gilbert EF, Jaeschke WF (1975) Prognostic factors of thyroid cancer: A long-term follow-up of 68 cases. Cancer 36:553–559
Tennvall J, Blörklund A, Möller T, Ranstam J, Åkerman M (1986) Is the EORTC prognostic index of thyroid cancer valid in differentiated thyroid carcinoma? Retrospective multivariate analysis of differentiated thyroid carcinoma with long follow-up. Cancer 57:1405–1414
Wanebo J, Andrews W, Kaiser D (1981) Thyroid cancer: Some basic considerations. Am J Surg 142:472–479
Mazzaferri EL, Young RL (1981) Papillary thyroid carcinoma: A 10-year follow-up report of the impact of therapy in 576 patients. Am J Med 70:511–518
Black M, Kink A Jr, Woolner LB (1960) Multicentricity of papillary adenocarcinoma of the thyroid: Influence on treatment. J Clin Endocrinol Metab 20:130–135
Tollefsen R, Shah JP, Huvos AG (1972) Papillary carcinoma of the thyroid; recurrence in the gland after initial surgical treatment. Am J Surg 124:468–472
Rose RG, Kelsey MP, Russell WO, Ibanez ML, White EC, Lee R, Clark (1963) Follow-up study of thyroid cancer treated by unilateral lobectomy. Am J Surg 106:494–500
Furukawa T, Tanaka H (1983) Introduction to Program Package of Multivariate Analysis (in Japanese). Igakusoin, Tokyo, p 32
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Mori, Y., Takaya, K., Miyata, Y. et al. Induction of discriminant function concerning postoperative local recurrence or distant metastasis in 589 patients with differentiated thyroid cancer. Surg Today 23, 777–785 (1993). https://doi.org/10.1007/BF00311619
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DOI: https://doi.org/10.1007/BF00311619