A Nomogram Predicting Central Lymph Node Metastasis for Patients with Papillary Thyroid Cancer

Abstract

PurposeCentral lymph node metastasis (CLNM) has been regarded as a predictor of relatively poor prognosis in patients with papillary thyroid carcinoma (PTC). Our study aimed to identify the risk factors for CLNM and develop a nomogram helping clinical decisions.MethodA total of 1,054 patients underwent thyroidectomy between January 2019 and September 2020 in the Second Affiliated Hospital of Chongqing Medical University. Among these patients, 747 patients with histopathologically confirmed PTC were included in this retrospective study. The perioperative clinical data of these patients were reviewed and analyzed. Univariate and multivariate logistic regression were used to analyze the correlation between clinicopathological characteristics and CLNM. A nomogram model was subsequently established and validated by a decision curve analysis (DCA) curve.Result33.6% (251/747) patients with PTC were confirmed with CLNM. And the CLNM was determined in 31.4% (168/535) non- Hashimoto’s thyroiditis (HT) patients and 39.2% (83/212) HT patients, respectively. 4 clinicopathological factors including gender, age, size, and HT were confirmed significantly associated with CLNM. The established nomogram showed promising discrimination and consistency in the study group with a C-index of 0.703. The decision curve analysis showed the nomogram has clinical feasibility.ConclusionOur data suggested that male gender, younger age, larger tumor size, and HT condition played a pivotal role in promoting the CLNM of PTC patients. And the nomogram we developed can help surgeons make the individualized clinical decision in PTC patients during preoperative and interoperative management.