Natural History and Prognostic Model of Untreated Papillary Thyroid Cancer: A SEER Database Analysis

Area of Science:

• Oncology
• Epidemiology
• Biostatistics

Background:

• Papillary thyroid cancer (PTC) is the most common type of thyroid malignancy.
• Understanding the natural history and progression of untreated PTC is crucial for risk stratification and management.
• Predictive models can aid in patient counseling and treatment planning.

Purpose of the Study:

• To analyze the progression patterns of untreated papillary thyroid cancer using the SEER database.
• To develop and validate a prognostic nomogram for predicting outcomes in patients with untreated PTC.

Main Methods:

• Data from the SEER database (2004-2020) for PTC patients were analyzed.
• Disease progression intervals were estimated using median survival times across different stages.
• Univariate and multivariate Cox regression identified prognostic factors in a training set.
• A nomogram was constructed based on identified independent risk factors.

Main Results:

• Early-stage (I-II) untreated PTC had favorable 10-year survival rates (86.34% and 66.03%).
• Advanced stages (III-IVC) showed poorer prognoses with median survival times decreasing significantly (108 to 8 months).
• Progression intervals from Stage III to IVC were 65, 23, and 12 months.
• Age, tumor stage, gender, and marital status were independent prognostic factors.

Conclusions:

• Untreated PTC progresses slowly in early stages, with a generally favorable prognosis.
• Disease progression accelerates and prognosis worsens with increasing tumor stage in advanced PTC.
• The developed nomogram, incorporating age, tumor stage, gender, and marital status, demonstrated good prognostic capability for untreated PTC.