Development and validation of a prognostic nomogram to predict overall survival and cancer-specific survival for patients with anaplastic thyroid carcinoma

Abstract

Background Anaplastic thyroid carcinoma (ATC) is a rare malignant tumor with a poor prognosis. However, there is no useful clinical prognostic predictive tool for ATC so far. Our study identified risk factors for survival of ATC and created a reliable nomogram to predict overall survival (OS) and cancer-specific survival (CSS) of patients with ATC. Methods A total of 1,404 cases of ATC diagnosed between 1983 and 2013 were extracted from on the Surveillance, Epidemiology and End Results database based on our inclusion criteria. OS and CSS were compared among patients between each variable by Kaplan–Meier methods. The Cox proportional hazards model was used to evaluate multiple prognostic factors and obtain independent predictors. All independent risk factors were included to build nomograms, whose accuracy and practicability were tested by concordance index (C-index), calibration curves, ROC curves, DCA, net reclassification improvement (NRI) and integrated discrimination improvement (IDI). Results Historic stage, tumor size, surgery and radiotherapy were independent risk factors associated with ATC according to multivariate Cox regression analysis of OS. However, gender was also an important prognostic predictor in CSS besides the factors mentioned above. These characteristics were included in the nomograms predicting OS and CSS of patients with ATC. The nomograms predicting OS and CSS performed well with a C-index of 0.765 and 0.773. ROC curves, DCA, NRI and IDI suggested that the nomogram was superior to TNM staging and age. Conclusion The proposed nomogram is a reliable tool based on the prediction of OS and CSS for patients with ATC. Such a predictive tool can help to predict the survival of the patients.

Differences Between Cancer-Specific Survival of Patients With Anaplastic and Primary Squamous Cell Thyroid Carcinoma and Factors Influencing Prognosis: A SEER Database Analysis

“…The survival rate of patients ≥ 65 years old was less than that of patients < 65 years old, confirming the findings of Gui et al. ( 12 ). Smallridge et al.…”

“…Age was a prognostic factor for CSS in patients with ATC. The survival rate of patients ≥ 65 years old was less than that of patients < 65 years old, confirming the findings of Gui et al (12). Smallridge et al (13) demonstrated that, for patients diagnosed with early ATC, surgical treatment, chemotherapy, radiotherapy, and systemic treatment can achieve optimal survival outcomes, while active palliative and clinical care are crucial for individuals with advanced ATC (14).…”

The Value of Multimodal Treatment in Anaplastic Thyroid Cancer Patients with Distant Metastasis

“…Age has been associated with thyroid cancer-speci c survival and is included in the AJCC staging system for patients with differentiated thyroid cancer [20]. In our study, being older than 65 years was a negative prognostic factor, which was consistent with the ndings of Gui and Wang et al [19,21]. The predictive value of tumor diameter was controversial in different studies [5,21,22], potentially due to the different cutoff values used in those studies.…”

Construction and Validation of a Convenient Clinical Nomogram to Predict the Risk of Brain Metastasis in Renal Cell Carcinoma Patients

“…However, to date, a convenient predictive model for predicting BM in RCC has not been developed, which means that the personal risk of BM cannot be accurately estimated by combining all independent risk factors for BM. Nomograms are an easyto-understand and multivariate visualization model to predict and quantify the incidence of a specific clinical outcome for individual patients and are widely applied in various malignancies [22][23][24]. Each independent risk factor included in the model was given a weighted point value to represent its effect on BM in RCC.…”