Nomograms for Differentiated Thyroid Carcinoma Patients Based on the Eighth AJCC Staging and Competing Risks Model

Area of Science:

• Oncology
• Biostatistics
• Epidemiology

Background:

• Differentiated thyroid carcinoma (DTC) patients exhibit long survival, making them susceptible to competing risks.
• Understanding prognostic factors for cause-specific death (CSD) and death due to other causes (DOC) is crucial for these patients.

Purpose of the Study:

• To develop and validate competing risks models for predicting CSD and DOC in DTC patients.
• To identify key prognostic factors influencing CSD and DOC in DTC.

Main Methods:

• Utilized the Surveillance, Epidemiology, and End Results (SEER) database, including 34,585 DTC patients.
• Employed the Fine and Gray subdistribution hazards model to construct nomograms for CSD and DOC.
• Validated nomogram performance using concordance indexes and calibration plots.

Main Results:

• Identified significant prognostic factors for CSD including pathological grade, tumor size, histology, AJCC-8 stage, surgery, radiotherapy, chemotherapy, and lymph node status.
• Identified prognostic factors for DOC including age, diagnosis year, sex, pathological grade, tumor size, AJCC-8 stage, surgery, radiotherapy, and lymph node ratio.
• Achieved high predictive accuracy with 1–5 year concordance indexes for CSD (0.913–0.942) and DOC (0.746–0.813), confirmed by calibration plots.

Conclusions:

• Developed validated nomograms for predicting CSD and DOC in DTC patients.
• These nomograms serve as valuable clinical tools for individualized risk assessment and prognosis.
• The models offer guiding value for clinical decision-making in DTC management.