Akslen developed two scores for evaluating prognosis in a patient with a papillary thyroid carcinoma. These can help identify patients who may require more aggressive management and closer monitoring. The author is from the Gade Institute at the University of Bergen in Norway.
Scores:
(1) VAN score for histologic grading (Vascular Invasion - Atypia Nuclei - Necrosis)
(2) SAG prognostic score (Sex - Age - Grade)
VAN Score
Parameters for VAN Score |
Finding |
Points |
---|---|---|
vascular invasion |
not involving medium to large blood vessels (may include questionable or small vessel invasion) |
0 |
|
definite invasion of medium to large blood vessels |
1 |
nuclear atypia |
not marked pleomorphism |
0 |
|
marked pleomorphism in worst field (based on pleomorphism and hyperchromasia) |
1 |
tumor necrosis |
absent |
0 |
|
present |
1 |
VAN score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• A tumor with a VAN score of 0 was termed Grade 1 (low grade).
• A tumor with a VAN score >= 1 was termed Grade 2 (high grade).
SAG Score
Parameters for SAG Score |
Finding |
Points |
---|---|---|
sex |
female |
0 |
|
male |
1 |
age of the patient |
< 70 years |
0 |
|
>= 70 years |
1 |
histologic grade (from VAN score) |
Grade 1 |
0 |
|
Grade 2 |
1 |
SAG score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
SAG Score |
SAG Group |
---|---|
0 |
I |
1 |
II |
2 or 3 |
III |
SAG Group |
Probability of Death from Thyroid Cancer in 10 Years |
Probability of Death from Thyroid Cancer in 15 Years |
---|---|---|
I |
1% |
2% |
II |
9% |
12% |
III |
52% |
61% |
Purpose: To evaluate a patient with a papillary carcinoma of the thyroid using the VAN and SAG scores of Aksten.
Specialty: Hematology Oncology, Surgery, general, Endocrinology
Objective: severity, prognosis, stage
ICD-10: C73,