Yang Tianqing, Hu Tingting, Zhao Mingyi, He Qingnan
Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha, China.
Front Oncol. 2022 Jul 11;12:919740. doi: 10.3389/fonc.2022.919740. eCollection 2022.
Stage IV Thyroid cancer (TC) has a relatively poor prognosis and lacks a precise and efficient instrument to forecast prognosis. Our study aimed to construct a nomogram for predicting the prognosis of patients with stage IV TC based on data from the SEER programme.
We enrolled patients diagnosed with TC from 2004 to 2015 in the study. Furthermore, the median survival time (MST) for the patients equalled 25 months. The patients were split into two groups: the training group and validation group. We used descriptive statistics to calculate demographic and clinical variables, Student's t test was used to describe continuous variables, and the chi-square test was used to describe classified variables. We used the concordance index (C-index) to evaluate discrimination ability and calibration plots to evaluate calibration ability. The improvement of the nomogram compared with the AJCC TNM system was evaluated by the net weight classification index (NRI), comprehensive discriminant rate improvement (IDI) and decision curve analysis (DCA).
There were 3501 patients contained within our cohort, and the median follow-up was 25 months [quartile range (IQR): 6-60] in the whole population, 25 months (IQR: 6-60) in the training cohort, and 25 months (IQR: 5-59) in the validation cohort. The C-index value of the training cohort equalled 0.86 (), and the value of the validation cohort equalled 0.85 The NRI values were as follows: training queue: 1.16 for three-year and 1.12 for five-year OS prediction; authentication group: 1.22 for three-year and 1.21 for five-year OS prediction. The IDI values were as follows: training cohort: 0.25 for three-year and 0.21 for five-year OS prediction; validation cohort: 0.27 for three-year and 0.21 for five-year OS prediction. The DCA diagram showed that the nomogram was superior in predicting the three-year and five-year trends.
Our nomogram can be used to forecast the survival of patients with stage IV TC.
IV期甲状腺癌（TC）预后相对较差，且缺乏精确有效的预后预测工具。我们的研究旨在基于监测、流行病学和最终结果（SEER）计划的数据构建一个预测IV期TC患者预后的列线图。
我们纳入了2004年至2015年诊断为TC的患者进行研究。此外，患者的中位生存时间（MST）为25个月。患者被分为两组：训练组和验证组。我们使用描述性统计来计算人口统计学和临床变量，采用Student's t检验描述连续变量，采用卡方检验描述分类变量。我们使用一致性指数（C指数）评估鉴别能力，使用校准图评估校准能力。通过净重分类指数（NRI）、综合判别率改善（IDI）和决策曲线分析（DCA）评估列线图相对于美国癌症联合委员会（AJCC）TNM系统的改进情况。
我们的队列中有3501例患者，总体人群的中位随访时间为25个月[四分位间距（IQR）：6 - 60]，训练队列中为25个月（IQR：6 - 60），验证队列中为25个月（IQR：5 - 59）。训练队列的C指数值为0.86（），验证队列的值为0.85。NRI值如下：训练队列：三年总生存（OS）预测为1.16，五年OS预测为1.12；验证组：三年OS预测为1.22，五年OS预测为1.21。IDI值如下：训练队列：三年OS预测为0.25，五年OS预测为0.21；验证队列：三年OS预测为0.27，五年OS预测为0.21。DCA图显示列线图在预测三年和五年趋势方面更具优势。
我们的列线图可用于预测IV期TC患者的生存情况。
