Development and validation of a prognostic nomogram for Hürthle cell thyroid carcinoma: a SEER-based study

Area of Science:

• Oncology
• Endocrinology
• Medical Statistics

Background:

• Hürthle cell carcinoma (HCTC) is a rare thyroid cancer subtype with unclear clinical behavior.
• Prognostic evaluation for HCTC remains challenging due to limited understanding of its biological characteristics.

Purpose of the Study:

• To develop nomogram models for predicting cancer-specific survival (CSS) and overall survival (OS) in patients with Hürthle cell thyroid carcinoma.
• To provide tools for individualized prognostic assessment and guide clinical decision-making in HCTC management.

Main Methods:

• Utilized data from 3,264 HCTC patients (2004-2018) from the Surveillance, Epidemiology, and End Results (SEER) database.
• Employed univariate and multivariate Cox regression analyses to identify significant prognostic predictors.
• Validated nomogram performance using concordance index (c-index), area under the receiver operating characteristic curve (AUC), and calibration curves.

Main Results:

• Identified key predictors for OS (age, sex, stage, tumor size, N/M stage, thyroidectomy) and CSS (age, stage, tumor size, N/M stage, AJCC stage, thyroidectomy).
• Achieved high predictive accuracy with c-indices of 0.822 for OS and 0.893 for CSS.
• Demonstrated excellent AUC values for 1-, 3-, and 5-year survival predictions, with good calibration between observed and predicted outcomes.

Conclusions:

• Developed and validated robust prognostic nomograms for Hürthle cell thyroid carcinoma.
• These nomograms enable individualized assessment of overall and cancer-specific survival.
• The developed nomograms can assist clinicians in making informed treatment decisions for HCTC patients.