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Nomogram to predict the risk of biochemical recurrence and structural recurrence in patients with stage cN1 papillary thyroid carcinoma

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Abstract

Introduction

Although papillary thyroid carcinoma (PTC) is thought to be the least aggressive thyroid cancer, it has a significant recurrence rate. Therefore, we aimed to develop a nomogram to estimate the probability of biochemical recurrence (BIR) and structural recurrence (STR) in patients with stage cN1 PTC.

Methods

We studied the relationship between the characteristics of patients with stage N1a PTC and the risk of recurrence by analysing the data of 617 inpatients (training cohort) and 102 outpatients (validation cohort) in our hospital. We used the least absolute shrinkage and selection operator regression model to identify prognostic indicators to construct nomograms to predict the risk of BIR and STR.

Results

There were 94 (15.24%) BIR cases in the training cohort and 36 (35.29%) in the validation cohort. There were 31 (5.02%) STR cases in the training cohort and 23 (22.55%) cases in the validation cohort. The variables included in the BIR nomogram were sex, age at diagnosis, tumour size, extrathyroidal infiltration, and lymph node ratio (LNR). While the variables included in the STR nomogram were tumour size, extrathyroidal infiltration, BRAF state, metastatic lymph nodes, and LNR. Both the prediction models demonstrated good discrimination ability. The results showed the calibration curve of the nomogram was near the optimum diagonal line, and the decision curve analysis showed a noticeably better benefit.

Conclusion

The LNR may be a valid prognostic indicator for patients with stage cN1 PTC. The nomograms could help clinicians identify high-risk patients and choose the best postsurgical therapy and monitoring.

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Availability of data and material

All data generated or analysed during this study are included in this published article.

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Funding

This study was supported by Academician He Lin Research Foundation of Affiliated Hospital of Jining Medical University (JYHL2022FMS10).

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Authors and Affiliations

  1. Department of Thyroid Surgery, Affiliated Hospital of Jining Medical University, Jining, 272000, Shandong Province, China

    Teng Ma, Peng Shi, Mei Liang & Yafei Shi

  2. Breast Disease Center, Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China

    Teng Ma & Tianyi Ma

  3. Department of Cardiovascular Surgery, Affiliated Hospital of Qingdao University, Qingdao, 266000, Shandong Province, China

    Lulu Wang

Authors
  1. Teng Ma
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  2. Peng Shi
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  3. Tianyi Ma
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  4. Mei Liang
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  5. Lulu Wang
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  6. Yafei Shi
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Contributions

TM designed the study, analysed the data, and commented on the manuscript at all stages. LW and PS collected the data. TM and ML revised the manuscript. YS provided the research direction.

Corresponding author

Correspondence to Yafei Shi.

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Competing interests

The authors declare that they have no competing interests.

Ethics approval and consent to participate

The experimental protocol was established, according to the ethical guidelines of the Helsinki Declaration and was approved by the Human Ethics Committee of Affiliated Hospital of Jining Medical University (2022C092).

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Ma, T., Shi, P., Ma, T. et al. Nomogram to predict the risk of biochemical recurrence and structural recurrence in patients with stage cN1 papillary thyroid carcinoma. J Cancer Res Clin Oncol 149, 11073–11083 (2023). https://doi.org/10.1007/s00432-023-04998-3

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  • DOI: https://doi.org/10.1007/s00432-023-04998-3

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