预测正在接受针对乳头甲状腺癌的积极监测的患者的疾病特异性生存率
Stanton Nielsen1,2, Kristine Kuchta1, Grace Huang1
1Department of Surgery, NorthShore University HealthSystem, Evanston, IL, USA.
World journal of surgery
|December 20, 2024
概括
这项研究开发了一种计算器,用于预测患有低风险乳头甲状腺癌 (PTC) 的患者的疾病特异性生存期 (DSS),考虑积极监测 (AS). 该工具通过提供关于生存结果的客观数据来帮助做出明智的决策.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 医疗信息学 医疗信息学
背景情况:
- 美国甲状腺协会的指导方针建议积极监测低风险的乳头甲状腺癌 (PTC).
- 对AS患者的选择需要仔细考虑个体风险因素.
- 需要客观的工具来支持PTC中AS的临床决策.
研究的目的:
- 开发和验证一个计算器,预测PTC患者的疾病特异性存活率 (DSS).
- 帮助临床医生和患者选择适合主动监测的候选人.
- 为管理低风险PTC提供数据驱动的见解.
主要方法:
- 利用了监测,流行病学和最终结果 (SEER) 数据库 (2004-2020年) 包括148,904名PTC患者.
- 进行了单变量和多变量分析,以确定DSS的显著预测因素.
- 开发了一个使用后勤回归的数学模型,在训练 (80%) 和验证 (20%) 集上进行了验证.
主要成果:
- 该计算器包含年龄,性别,种族,家庭收入中位数,瘤大小和结节状况.
- 对于5年和10年的DSS (曲线下的面积>0.81) 实现了高预测准确度.
- 通过示例患者场景展示了该工具的实用性,展示了基于人口统计和管理选择的差异性DSS预测.
结论:
- 一个经过验证的计算器可以准确地预测PTC患者的DSS,考虑AS.
- 该工具支持在低风险PTC中进行主动监测的知情决策.
- 来自该计算器的客观数据增强了患者对AS的选择.
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