Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Internal Medicine Department, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Sci Rep. 2024 Oct 7;14(1):23349. doi: 10.1038/s41598-024-72002-0.
This study explored the role of radioiodine therapy (RAI) in low-risk thyroid cancer patients and examined the disease-specific survival (DSS) rates in a large cohort of differentiated thyroid cancer patients (DTC). We obtained patient data from SEER database. Patients who underwent total thyroidectomy were included and categorized into three groups based on histology: classical papillary thyroid carcinoma (C-PTC), follicular type variant carcinoma (FV-PTC), and follicular thyroid cancer (FTC). Patients with distant metastasis, tumor size ≥ 200 mm, chemotherapy, or any type of radiation other than RAI were also excluded. A nomogram was developed and tested for discrimination and calibration. In total, 96,532 thyroid cancer cases were examined, including 59,460 C-PTC, 31,583 FV-PTC, and 5,489 FTC cases. Age > 65 years and male sex were correlated with lower survival rates across the subtypes. In addition, extrathyroidal extension had a worse survival effect in patients with FTC. DSS rates were compared between patients who received RAI and those who did not, with a 3% difference in C-PTC (94% vs. 91%, p < 0.001), 2% in FV-PTC (92% vs. 90%, p < 0.001), and 1% in FTC (89% vs. 88%, p = 0.084) at 15 years. The nomograms for long-term DSS showed high discriminatory abilities with C-indices of 0.815, 0.805, and 0.781 for C-PTC, FV-PTC, and FTC, respectively. The developed nomogram can be used in the treatment plan for patients with DTC. Our study emphasizes the prognostic factors for DTC and highlights the need for personalized treatment plans based on individual risk profiles.
这项研究探讨了放射性碘治疗（RAI）在低危甲状腺癌患者中的作用，并在一大群分化型甲状腺癌（DTC）患者中检查了疾病特异性生存率（DSS）。我们从 SEER 数据库中获取了患者数据。纳入了接受甲状腺全切除术的患者，并根据组织学分为三组：经典型乳头状甲状腺癌（C-PTC）、滤泡型变体癌（FV-PTC）和滤泡状甲状腺癌（FTC）。排除了有远处转移、肿瘤大小≥200mm、化疗或任何类型的除 RAI 以外的放射治疗的患者。开发了一个列线图并进行了区分度和校准度的测试。共检查了 96532 例甲状腺癌病例，其中包括 59460 例 C-PTC、31583 例 FV-PTC 和 5489 例 FTC 病例。年龄>65 岁和男性与各亚型的生存率降低相关。此外，甲状腺外侵犯对 FTC 患者的生存影响更差。比较了接受 RAI 和未接受 RAI 的患者的 DSS 率，C-PTC 组差异为 3%（94%比 91%，p<0.001），FV-PTC 组差异为 2%（92%比 90%，p<0.001），FTC 组差异为 1%（89%比 88%，p=0.084）。15 年时，用于长期 DSS 的列线图显示出较高的区分能力，C 指数分别为 0.815、0.805 和 0.781，用于 C-PTC、FV-PTC 和 FTC。该开发的列线图可用于 DTC 患者的治疗计划。我们的研究强调了 DTC 的预后因素，并强调了根据个体风险概况制定个性化治疗计划的必要性。
