Abstract
Background
Nomogram could estimate individualized prognosis in papillary thyroid carcinoma (PTC). We aimed to create and validate a new nomogram and compare it with other published nomograms using a large patient cohort.
Methods
Eight-hundred and forty-nine PTC patients with ≥7 years follow-up were randomly assigned to the development (n = 425) and validation (n = 424) groups. The former was used for developing a nomogram for disease-specific survival (DSS), while the latter was for validating the nomogram by discrimination [or area under curve (AUC)]. AUC of the newly developed nomogram was compared to other published nomograms.
Results
The 5- and 10-year risk of dying from PTC were 1.4 and 3.3 %, respectively, while dying from non-PTC-related causes were 2.3 and 5.1 %, respectively. The new nomogram was developed from age, tumor size, multifocality, nodal status and distant metastases. The discrimination was excellent (AUC (95 % CI) for 5- and 10-year DSS were 0.896 (0.683–0.971) and 0.919 (0.871–0.967), respectively). Its predictability was similar to other published nomograms (p > 0.05). Based on the new nomogram, a total score of <28 meant 99.72 % chance of surviving from PTC at 10 years while a score of ≥28 meant 9.09 % chance of dying from PTC at 10 years.
Conclusions
Using variables from the current tumor node metastasis (TNM) staging system, a new nomogram was developed. It exhibited excellent discriminatory ability and accuracy in predicting 10-year DSS relative to other published nomograms. However, given the excellent prognosis of PTC, the new nomogram was better at ruling out than predicting PTC-related death. Further validation by an external cohort is required.
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Acknowledgments
We like to acknowledge Professor K. Alok Pathak from the University of Manitoba, Canada and Dr. Limin Yang from National Research Institute for Child Health and Development, Japan for generously providing a more detailed scoring algorithm of their respected nomogram.
Disclosures
All authors had nothing to disclose. No competing financial interests exist.
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Lang, B.HH., Wong, C.K.H. Validation and Comparison of Nomograms in Predicting Disease-Specific Survival for Papillary Thyroid Carcinoma. World J Surg 39, 1951–1958 (2015). https://doi.org/10.1007/s00268-015-3044-2
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DOI: https://doi.org/10.1007/s00268-015-3044-2