Ge Ming-Hua, Cao Jun, Wang Jin-Yu, Huang Yu-Qing, Lan Xia-Bin, Yu Bin, Wen Qing-Liang, Cai Xiu-Jun
College of Medicine, Zhejiang University Department of Head and Neck Surgery Medical Record Department, Zhejiang Cancer Hospital Zhejiang Chinese Medical University Department of General Surgery, Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.
Medicine (Baltimore). 2017 Jul;96(30):e7575. doi: 10.1097/MD.0000000000007575.
The study aimed to establish effective nomograms for prediction of tumor regional recurrence and distant recurrence of papillary thyroid carcinoma (PTC) patients after partial or total thyroidectomy.These nomograms were based on a retrospective study on 1034 patients who underwent partial or total thyroidectomy for PTC. The predictive accuracy and discriminative ability of the nomograms were evaluated by the concordance index (C-index) and calibration curve. In addition, a validation cohort was included at the same institution.Multivariate analysis demonstrated that family history, maximal tumor diameter, capsular invasion, and lymph node staging were independent risk factors for regional recurrence-free survival; and family history, histological variants, capsular invasion, perineuronal invasion, and vascular invasion were independent risk factors for distant recurrence-free survival. They were selected into the 2 nomograms, respectively, and the C-index for regional recurrence-free survival and distant recurrence-free survival prediction were 0.72 and 0.83, respectively. In the validation cohort, the 2 nomograms displayed a C-index of 0.72 and 0.89, respectively.The nomograms developed in this study demonstrated their discrimination capability for predicting 3 and 5-year regional recurrence and distant recurrence after partial or total thyroidectomy, and can be used to identify high-risk patients.
本研究旨在建立有效的列线图，以预测甲状腺乳头状癌（PTC）患者在部分或全甲状腺切除术后的肿瘤区域复发和远处复发。这些列线图基于对1034例行PTC部分或全甲状腺切除术患者的回顾性研究。通过一致性指数（C指数）和校准曲线评估列线图的预测准确性和判别能力。此外，在同一机构纳入了一个验证队列。多因素分析表明，家族史、最大肿瘤直径、包膜侵犯和淋巴结分期是区域无复发生存的独立危险因素；家族史、组织学变异、包膜侵犯、神经周侵犯和血管侵犯是远处无复发生存的独立危险因素。它们分别被纳入2个列线图，区域无复发生存和远处无复发生存预测的C指数分别为0.72和0.83。在验证队列中，这2个列线图的C指数分别为0.72和0.89。本研究开发的列线图显示了其对部分或全甲状腺切除术后3年和5年区域复发和远处复发的判别能力，可用于识别高危患者。
