Survival trends and conditional survival in patients with pulmonary metastases from differentiated thyroid carcinoma

Patients with pulmonary metastases from differentiated thyroid carcinoma (DTC) have a significantly poorer prognosis compared to DTC patients without metastases. This study aimed to establish a nomogram combined with dynamic survival analysis to predict the survival probability of patients with pulmonary metastases from differentiated thyroid carcinoma and compensate for the underestimation of survival in patients with very poor prognosis.

Patient data were collected from the Surveillance, Epidemiological, and End Result (SEER) data resource from 2010 to 2019. Multivariate analysis was carried out by the Cox proportional hazards regression to construct a nomogram. Receiver operating characteristic (ROC) curves along with calibration were employed to assess the effectiveness of the model.The life table was used to estimate the conditional cancer-specific survival (CSS).

In the training set, the AUCs for the CSS nomogram were 0.728, 0.741, and 0.779, with a c-index of 0.682, indicating good predictive performance at 3, 5, and 10 years. In the validation set, the AUCs for the CSS nomogram were 0.706, 0.726, and 0.769, with a c-index of 0.696, while the AUCs for the 8th TNM staging system were 0.521, 0.555, and 0.601, with a c-index of 0.579. The overall 5-year conditional survival rate for patients increased slightly from 63.44 to 70.52%. The survival gap was greatest between patients aged <55 years and those aged ≥55 years.

We established a nomogram combined with dynamic survival analysis, which serve as promising options for prognosis estimation, to enhance personalized evaluation of survival risks and provide the basis for the development of more clinical treatment approaches.