Nomogram models for predicting outcomes in thyroid cancer patients with distant metastasis receiving ¹³¹iodine...

This study aimed to establish and validate prognostic nomogram models for patients who underwent ¹³¹I therapy for thyroid cancer with distant metastases. The cohort was divided into training (70%) and validation (30%) sets for nomogram development. Univariate and multivariate Cox regression analyses were used to identify independent predictors for overall survival (OS) and progression-free survival (PFS). Nomograms were developed based on these predictors, and Kaplan-Meier curves were constructed for validation. Among 451 patients who were screened, 412 met the inclusion criteria and were followed-up for a median duration of 65.2 months. The training and validation sets included 288 and 124 patients, respectively. Pathological type, first ¹³¹I administrated activity, and lesion ¹³¹I uptake in lesions were independent predictors for PFS. For OS, predictors included gender, age, metastasis site, first ¹³¹I administrated activity, ¹³¹I uptake, pulmonary lesion size, and stimulated thyroglobulin levels. These predictors were used to construct nomograms for predicting PFS and OS. Low-risk patients had significantly longer PFS and OS compared to high-risk patients, with 10-year PFS rates of 81.1% vs. 51.9% and 10-year OS rates of 86.2% vs. 37.4%. These may aid individualized prognostic assessment and clinical decision-making, especially in determining the prescribed activity for the first ¹³¹I treatment.