Postoperative Nomogram for predicting Cancer-Specific and Overall Survival Among Patients with Medullary Thyroid Cancer

Abstract

Background Medullary thyroid carcinoma (MTC) accounts for 1% -2% of thyroid cancer in the United States based on the latest Surveillance, Epidemiology, and End Results (SEER) data, this study aimed to construct a comprehensive predictive nomogram based on various clinical variables in MTC patients who undergo total thyroidectomy and neck lymph nodes dissection.Methods Data regarding 1237 MTC patients who undergo total thyroidectomy and neck lymph nodes dissection from 2004 to 2015 were obtained from the SEER database. Univariate and multivariate Cox regression analyses were used to screen for meaningful independent predictors. These independent factors were used to construct a nomogram model, a survival prognostication tool for 3- and 5-year overall survival and cancer-specific survival among these MTC patients.Result A total of 1237 patients enrolled from the SEER database were randomly divided into the training group (n = 867) and the test group (n = 370). Univariate and multivariate Cox regression analyses were used to identify meaningful independent prognostic factors (P <0.05). Tumor size, age, metastasis status, and LNR were selected as independent predictors of overall survival (OS) and cancer-specific survival (CSS). Finally, two nomograms were developed, the predicted C-index of overall survival (OS) and cancer-specific survival (CSS) rate in the training group were 0.828 and 0.904, respectively. The predicted C-index of overall survival (OS) and cancer-specific survival (CSS) rate in the test group were 0.813 and 0.828.Conclusion Nomograms constructed by using various clinical variables can make more comprehensive and accurate predictions for MTC patients who undergo total thyroidectomy and neck lymph nodes. These predictive nomograms help identify postoperative high-risk MTC patients and facilitate patient counseling on clinical prognosis and follow-up.