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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1408118

Construction and Validation of Prognostic Nomograms for Older Differentiated Thyroid Cancer Patients: A Population-Based Study Utilizing the SEER Database

Provisionally accepted
Yunkai Mu Yunkai Mu 1Jiuyi Wang Jiuyi Wang 1Kaijun Bai Kaijun Bai 2*Bi Huang Bi Huang 3*Guibo Feng Guibo Feng 1*
  • 1 Yongchuan Hospital of Chongqing Medical University, Chongqing, China
  • 2 Other, Chongqing, China
  • 3 Second Affiliated Hospital, Chongqing Medical University, Chongqing, China

The final, formatted version of the article will be published soon.

    Objective Differentiated thyroid cancer (DTC) represents a prevalent pathological subtype of thyroid malignancies and is among the common malignant tumor subtypes in the population. Currently, few survival prognosis studies have focused on older patients with DTC. Our aim was to develop and validate a nomogram for predicting overall survival (OS) and cancer-specific survival (CSS) among older DTC patients. Results A total of 7239 confirmed older DTC patients were included in the study. Patients diagnosed from 2004 to 2015 were randomly assigned to a training group (n=3891) or a validation group (n=1668) at a 7:3 ratio. Patients diagnosed between 2016 and 2018 were allocated to an external validation group (n=1680). The OS nomogram comprised 8 variables (surgery, M stage, tumor size, tumor stage, tumor grade, marital status, sex, and age). The cancer-specific survival nomogram included 9 factors (surgery, M stage, N stage, tumor size, stage, grade, histological type, marital status, and age). The C-indexes for the OS nomogram were 0.726 (95% CI=0.706-0.746) and 0.762 (95% CI=0.732-0.791). According to the CSS nomogram, the C-indexes for the training cohort at 4, 6, and 9 years were 96, 86.9, and 86.8, respectively, and for the validation cohort, they were 90.4, 91.2, and 90.8, respectively. The nomograms demonstrated good calibration with the ideal 2 calibration curve in both the training and validation cohorts. Decision curve analysis confirmed the clinical predictive value of the survival probabilities predicted by the nomograms. Compared with TNM staging, the nomograms were able to stratify patients more accurately and demonstrated greater accuracy and predictive ability. Conclusion This study represents the first attempt to construct nomogram prediction models for older DTC patients.Future research should focus on refining these models with continuously updated tumor prognostic factors and adopting personalized prognostic values to guide subsequent management strategies for patients.

    Keywords: Differentiated thyroid cancer, older patients, Prediction model, nomogram, SEER database

    Received: 27 Mar 2024; Accepted: 02 May 2024.

    Copyright: © 2024 Mu, Wang, Bai, Huang and Feng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Kaijun Bai, Other, Chongqing, China
    Bi Huang, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
    Guibo Feng, Yongchuan Hospital of Chongqing Medical University, Chongqing, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.