Development and Evaluation of Prognostic Nomogram for Patients with Differentiated Thyroid Carcinoma

Abstract

Abstract Background : Papillary thyroid carcinoma and follicular thyroid carcinoma are both well-differentiated thyroid carcinomas. Here, we aimed to establish and evaluate a nomogram for patients with differentiated thyroid cancer. Methods : Patient records were available from SEER database. We enrolled 17,659 patients in total and randomly separated them into a modeling cohort (n = 12,363, 70%) and a validation cohort (n = 5,296, 30%). Predictive models were established via univariate and multivariate Cox regression analysis of potential risk factors and used to produce a nomogram. Performance of the nomograms in terms of discrimination ability and calibration was evaluated by determining the concordance index (C-index) and by generating calibration plots, respectively, using the internal (modeling cohort) and external (validation cohort) validity. Results : Seven independent prognostic factors (age, race, sex, grade, AJCC T stage, AJCC N stage, and AJCC M stage) were identified and used to develop the nomogram for OS prediction of patients with DTC. The C-index for the modeling cohort was 0.829 (95% CI: 0.807-0.851), and the C-index for the validation cohort was 0.833 (95% CI: 0.803-0.862). Calibration plots of the nomogram indicated acceptable agreement between the predicted 3-, 5-year survival rates and the actual observations in the modeling and validation groups. Conclusions : We have constructed and verified a nomogram containing clinical factors, which showed better prognostic judgment and predictive accuracy for DTC. This will enable clinicians and patients to easily personalize and quantify the probability of DTC during the postoperative period.

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