Description

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%

 


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