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RESEARCH ARTICLE

The Delayed Risk Stratification System in the Risk of Differentiated Thyroid Cancer Recurrence Aldona Kowalska1*, Agnieszka Walczyk1, Iwona Pałyga1, Danuta Gąsior-Perczak1, Klaudia Gadawska-Juszczyk1, Monika Szymonek1, Tomasz Trybek1, Katarzyna LizisKolus1, Dorota Szyska-Skrobot1, Estera Mikina1, Stefan Hurej1, Janusz Słuszniak2, Ryszard Mężyk3, Stanisław Góźdź4,5 1 Departments of Endocrinology, Holycross Cancer Centre, Kielce, Poland, 2 Department of Surgical Oncology, Holycross Cancer Centre, Kielce, Poland, 3 Department of Cancer Epidemiology, Holycross Cancer Centre, Kielce, Poland, 4 Department of Clinical Oncology; Holycross Cancer Centre, Kielce, Poland, 5 The Faculty of Health Sciences, Jan Kochanowski University, Kielce, Poland

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* [email protected]

Abstract Context OPEN ACCESS Citation: Kowalska A, Walczyk A, Pałyga I, GąsiorPerczak D, Gadawska-Juszczyk K, Szymonek M, et al. (2016) The Delayed Risk Stratification System in the Risk of Differentiated Thyroid Cancer Recurrence. PLoS ONE 11(4): e0153242. doi:10.1371/journal. pone.0153242 Editor: Paula Soares, IPATIMUP/Faculty of Medicine of the University of Porto, PORTUGAL Received: January 6, 2016 Accepted: March 27, 2016 Published: April 14, 2016 Copyright: © 2016 Kowalska et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper. Funding: The study was funded by Holycross Cancer Centre. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.

There has been a marked increase in the detection of differentiated thyroid carcinoma (DTC) over the past few years, which has improved the prognosis. However, it is necessary to adjust treatment and monitoring strategies relative to the risk of an unfavourable disease course.

Materials and Methods This retrospective study examined data from 916 patients with DTC who received treatment at a single centre between 2000 and 2013. The utility of the American Thyroid Association (ATA) and the European Thyroid Association (ETA) recommended systems for early assessment of the risk of recurrent/persistent disease was compared with that of the recently recommended delayed risk stratification (DRS) system.

Results The PPV and NPV for the ATA (24.59% and 95.42%, respectively) and ETA (24.28% and 95.68%, respectively) were significantly lower than those for the DRS (56.76% and 98.5%, respectively) (p