Nomograms for Differentiated Thyroid Carcinoma Patients Based on the Eighth AJCC Staging and Competing Risks Model

Overview

Journal JNCI Cancer Spectr

Publisher Oxford University Press

Specialty Oncology

Date 2021 Jun 23

PMID 34159295

Citations 1

Authors

Chengzhuo Li

Fengshuo Xu

Qiao Huang

Didi Han

Shuai Zheng

Wentao Wu

Fanfan Zhao

Xiaojie Feng

Jun Lyu

Affiliations

Soon will be listed here.

Abstract

Background: Differentiated thyroid carcinoma (DTC) patients have a long survival period and good prognosis, so they are easily affected by competing risk events. The purpose of this study was to use the competing risks model to identify prognostic factors for cause-specific death (CSD) and death due to other causes (DOC) in patients with DTC.

Methods: Our screening process identified 34 585 DTC patients in the Surveillance, Epidemiology, and End Results database and randomly divided them into a training cohort and a validation cohort. We used the Fine and Gray subdistribution hazards model to establish the CSD and DOC nomograms. The distinguishing ability and consistency of the nomograms were evaluated using the consistency indexes and calibration plots.

Results: Our analysis of a competing risks model revealed that pathological grade, tumor size, histological type, American Joint Committee on Cancer (AJCC)-8 stage, surgery status, adjuvant radiotherapy status, adjuvant chemotherapy status, and log odds of positive lymph nodes are prognostic factors for CSD, and age at diagnosis, year of diagnosis, sex, pathological grade, tumor size, AJCC-8 stage, surgery status, adjuvant radiotherapy status, and lymph node ratio are prognostic factors for DOC. The 1-year, 3-year, and 5-year concordance indexes in the validation cohorts were 0.942, 0.931, and 0.913 for the CSD nomogram and 0.813, 0.746, and 0.776 for the DOC nomogram. The calibration plots showed good consistency in both nomograms.

Conclusions: Our nomograms can be used as a tool to help clinicians individually predict the probability of CSD and DOC in DTC patients at 1 year, 3 years, and 5 years, which has certain guiding value in clinical applications.

Citing Articles

Scoring system and a simple nomogram for predicting radioiodine refractory differentiated thyroid cancer: a retrospective study.

Liu Y, Wang Y, Zhang W EJNMMI Res. 2022; 12(1):45.

PMID: 35904608 PMC: 9338217. DOI: 10.1186/s13550-022-00917-8.

References

Yang J, Li Y, Liu Q, Li L, Feng A, Wang T . Brief introduction of medical database and data mining technology in big data era. J Evid Based Med. 2020; 13(1):57-69. PMC: 7065247. DOI: 10.1111/jebm.12373. View

Davies L, Welch H . Current thyroid cancer trends in the United States. JAMA Otolaryngol Head Neck Surg. 2014; 140(4):317-22. DOI: 10.1001/jamaoto.2014.1. View

Tang J, Jiang S, Gao L, Xi X, Zhao R, Lai X . Construction and Validation of a Nomogram Based on the Log Odds of Positive Lymph Nodes to Predict the Prognosis of Medullary Thyroid Carcinoma After Surgery. Ann Surg Oncol. 2021; 28(8):4360-4370. DOI: 10.1245/s10434-020-09567-3. View

Rahib L, Smith B, Aizenberg R, Rosenzweig A, Fleshman J, Matrisian L . Projecting cancer incidence and deaths to 2030: the unexpected burden of thyroid, liver, and pancreas cancers in the United States. Cancer Res. 2014; 74(11):2913-21. DOI: 10.1158/0008-5472.CAN-14-0155. View

Schumacher P, Dineen S, Barnett Jr C, Fleming J, Anthony T . The metastatic lymph node ratio predicts survival in colon cancer. Am J Surg. 2007; 194(6):827-31. DOI: 10.1016/j.amjsurg.2007.08.030. View

Kutikov A, Egleston B, Canter D, Smaldone M, Wong Y, Uzzo R . Competing risks of death in patients with localized renal cell carcinoma: a comorbidity based model. J Urol. 2012; 188(6):2077-83. PMC: 4659779. DOI: 10.1016/j.juro.2012.07.100. View

Tong Y, Huang Z, Hu C, Chi C, Lv M, Li P . Independent risk factors evaluation for overall survival and cancer-specific survival in thyroid cancer patients with bone metastasis: A study for construction and validation of the predictive nomogram. Medicine (Baltimore). 2020; 99(36):e21802. PMC: 7478775. DOI: 10.1097/MD.0000000000021802. View

Yang C, Gardiner L, Wang H, Hueman M, Chen D . Creating Prognostic Systems for Well-Differentiated Thyroid Cancer Using Machine Learning. Front Endocrinol (Lausanne). 2019; 10:288. PMC: 6517862. DOI: 10.3389/fendo.2019.00288. View

Menon B, dEsterre C, Qazi E, Almekhlafi M, Hahn L, Demchuk A . Multiphase CT Angiography: A New Tool for the Imaging Triage of Patients with Acute Ischemic Stroke. Radiology. 2015; 275(2):510-20. DOI: 10.1148/radiol.15142256. View

10.

Chen L, Chung K, Chang Y, Chang Y . Ratio and log odds of positive lymph nodes in breast cancer patients with mastectomy. Surg Oncol. 2015; 24(3):239-47. DOI: 10.1016/j.suronc.2015.05.001. View

11.

Austad S, Fischer K . Sex Differences in Lifespan. Cell Metab. 2016; 23(6):1022-1033. PMC: 4932837. DOI: 10.1016/j.cmet.2016.05.019. View

12.

Berry S, Ngo L, Samelson E, Kiel D . Competing risk of death: an important consideration in studies of older adults. J Am Geriatr Soc. 2010; 58(4):783-7. PMC: 2873048. DOI: 10.1111/j.1532-5415.2010.02767.x. View

13.

Akslen L, Livolsi V . Prognostic significance of histologic grading compared with subclassification of papillary thyroid carcinoma. Cancer. 2000; 88(8):1902-8. View

14.

Wang Y, Wu J, He H, Ma H, Hu L, Wen J . Nomogram predicting cancer-specific mortality in early-onset rectal cancer: a competing risk analysis. Int J Colorectal Dis. 2020; 35(5):795-804. DOI: 10.1007/s00384-020-03527-9. View

15.

Schmidbauer B, Menhart K, Hellwig D, Grosse J . Differentiated Thyroid Cancer-Treatment: State of the Art. Int J Mol Sci. 2017; 18(6). PMC: 5486113. DOI: 10.3390/ijms18061292. View

16.

Wen Q, Yu Y, Yang J, Wang X, Wen J, Wen Y . Development and Validation of a Nomogram for Predicting Survival in Patients with Thyroid Cancer. Med Sci Monit. 2019; 25:5561-5571. PMC: 6681685. DOI: 10.12659/MSM.915620. View

17.

Jin C, Deng X, Li Y, He W, Yang X, Liu J . Lymph node ratio is an independent prognostic factor for rectal cancer after neoadjuvant therapy: A meta-analysis. J Evid Based Med. 2018; 11(3):169-175. DOI: 10.1111/jebm.12289. View

18.

Wang J, Hassett J, Dayton M, Kulaylat M . The prognostic superiority of log odds of positive lymph nodes in stage III colon cancer. J Gastrointest Surg. 2008; 12(10):1790-6. DOI: 10.1007/s11605-008-0651-3. View

19.

Raue F, Frank-Raue K . Thyroid Cancer: Risk-Stratified Management and Individualized Therapy. Clin Cancer Res. 2016; 22(20):5012-5021. DOI: 10.1158/1078-0432.CCR-16-0484. View

20.

Kim T, Kim Y, Kim H, Park S, Choe J, Kim J . Prognostic value of the eighth edition AJCC TNM classification for differentiated thyroid carcinoma. Oral Oncol. 2017; 71:81-86. DOI: 10.1016/j.oraloncology.2017.06.004. View