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Construction of prediction models for determining the risk of lateral lymph node metastasis in patients with thyroid papillary carcinoma based on gender stratification

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Abstract

Background

Lateral lymph node metastasis (LLNM) is associated with poor prognosis in patients with papillary thyroid cancer (PTC). The purpose of this study was to determine the risk factors for LLNM and establish prediction models that could individually assessed the risk of LLNM.

Methods

A total of 619 PTC patients were retrospectively analyzed in our study. Univariate and multivariate analysis were performed for male and female patients, respectively, to assess relationships between clinicopathological features and LLNM. By integrating independent predictors selected by binary logistic regression modeling, preoperative and postoperative nomograms were developed to estimate the risk of LLNM.

Results

LLNM was detected in 80 of 216 male patients. Of 403 female patients, 114 had LLNM. The preoperative nomogram of male patients included three clinical variables: the number of foci, tuner size, and echogenic foci. In addition to the above three variables, the postoperative nomogram of male patients included extrathyroidal extension (ETE) detected in surgery, central lymph node metastasis (CLNM) and high-volume CLNM. The preoperative nomogram of female patients included the following variables: age, chronic lymphocytic thyroiditis (CLT), BRAF V600E, the number of foci, tumor size and echogenic foci. Variables such as CLT, BRAF V600E, the number of foci, tumor size, ETE detected in surgery, CLNM, high-volume CLNM and central lymph node ratio were included in the postoperative nomogram. Above Nomograms show good discrimination.

Conclusions

Considering the difference in the incidence rate of LLNM between men and women, a separate prediction system should be established for patients of different genders. These nomograms are helpful in promoting the risk stratification of PTC treatment decision-making and postoperative management.

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Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. The Third Affiliated Hospital of Soochow University, Changzhou First People’s Hospital, Changzhou, Jiangsu, China

    Wan-Xiao Wu, Gao-Feng Qi, Jia-Wei Feng, Jing Ye, Li-Zhao Hong, Fei Wang, Sheng-Yong Liu & Yong Jiang

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  1. Wan-Xiao Wu
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  2. Gao-Feng Qi
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  3. Jia-Wei Feng
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  4. Jing Ye
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  5. Li-Zhao Hong
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  7. Sheng-Yong Liu
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  8. Yong Jiang
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Contributions

W-XW and L-ZH: writing—original draft, software, data curation. S-YL: validation, formal analysis, data curation. FW and G-FQ: conceptualization. JY: validation, investigation. J-WF and YJ: writing—review and editing, visualization, supervision.

Corresponding author

Correspondence to Yong Jiang.

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Conflict of interest

This manuscript has not been published nor submitted for publication elsewhere. All authors have contributed significantly, and agree with the content of the manuscript. The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article.

Ethical approval

This study has been approved by the Institutional Review Board of Changzhou First People’s Hospital ethics committee, and has been performed according to the ethical standards laid down in the 1964 Declaration of Helsinki.

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Due to the retrospective nature of this study, the need for informed consent was waived.

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Wu, WX., Qi, GF., Feng, JW. et al. Construction of prediction models for determining the risk of lateral lymph node metastasis in patients with thyroid papillary carcinoma based on gender stratification. Eur Arch Otorhinolaryngol 280, 2511–2523 (2023). https://doi.org/10.1007/s00405-022-07812-x

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  • DOI: https://doi.org/10.1007/s00405-022-07812-x

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