Department of Thyroid and Breast Surgery, First Affiliated Hospital of Fujian Medical University, 20 Cha Zhong Road, Tai Jiang District, Fuzhou, 350005, Fujian Province, China.
Updates Surg. 2022 Apr;74(2):735-746. doi: 10.1007/s13304-021-01103-6. Epub 2021 Jun 4.
Follicular thyroid carcinoma (FTC) is an indolent carcinoma. The cumulative incidence of death from patients with FTC and the nomogram built based on the competing risks model have not been described.
The data from patients diagnosed with primary FTC were identified and extracted from the surveillance, epidemiology, and end results (SEER) program (1988-2015). The cumulative incidence function was utilized to calculate the likelihood of death resulting from thyroid cancer and other causes, respectively. Gray's test was used to examine the difference in the cumulative incidence of death between the groups. A tenfold cross-validation was applied to assess the discrimination and calibration of the model.
A total of 9210 patients diagnosed with primary FTC were included. The median follow-up time was 92 months (1-347 months). The 5-year, 10-year, and 20-year probabilities of death from FTC were 2.84%, 5.23%, and 8.61%, respectively. The age at diagnosis, sex, tumor size, pathological subtypes, tumor extension, lymph node involvement, as well as surgical and radiotherapy methods used, were related to the cumulative incidence of death. Multivariate analysis identified several risk factors for patient survival. The model behaved well in terms of performance. A nomogram based on the model allowed the prediction of the probability of death among patients with FTC.
The prognosis of FTC is excellent. The likelihood of death caused by thyroid cancer increases with age. Male sex, tumors larger than 4 cm, invasion, extrathyroidal extension, lymph node involvement, and distant metastases increase the risk of dying of thyroid carcinoma. The nomogram constructed on the basis of the model is potentially useful for both clinicians and patients.
滤泡状甲状腺癌（FTC）是一种惰性癌。尚未描述 FTC 患者死亡的累积发生率和基于竞争风险模型建立的列线图。
从监测、流行病学和最终结果（SEER）计划（1988-2015 年）中确定并提取出诊断为原发性 FTC 的患者的数据。利用累积发生率函数分别计算因甲状腺癌和其他原因导致死亡的可能性。采用 Gray 检验比较各组之间的死亡累积发生率差异。应用十折交叉验证评估模型的区分度和校准度。
共纳入 9210 例原发性 FTC 患者。中位随访时间为 92 个月（1-347 个月）。FTC 患者 5 年、10 年和 20 年的死亡概率分别为 2.84%、5.23%和 8.61%。诊断时的年龄、性别、肿瘤大小、病理亚型、肿瘤扩展、淋巴结受累以及手术和放疗方法与死亡的累积发生率相关。多变量分析确定了影响患者生存的几个风险因素。该模型在性能方面表现良好。基于该模型的列线图可用于预测 FTC 患者的死亡概率。
FTC 的预后良好。因甲状腺癌导致的死亡概率随年龄增加而上升。男性、肿瘤大于 4cm、侵袭性、甲状腺外侵犯、淋巴结受累和远处转移增加了因甲状腺癌死亡的风险。基于该模型构建的列线图对临床医生和患者均具有潜在的应用价值。
