Nomogram for predicting central lymph node metastasis in papillary thyroid microcarcinoma: A retrospective cohort study of 8668 patients

Wang, Yunjun; Guan, Qing; Xiang, Jun

doi:10.1016/j.ijsu.2018.05.023

Cited by 61 publications

(67 citation statements)

References 35 publications

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“…Some characteristics, such as multifocality and bilaterality, have been regarded as independent predictors of CLNM and LLNM in other studies. [4][5][6][8][9][10] In our study, however, bilaterality was not an independent predictor of either of these forms of LNM, whereas multifocality was only an independent predictor of CLNM, but not of LLNM.…”

Section: Discussioncontrasting

confidence: 84%

“…2,3 Previous studies have shown that the incidence rate of central LNM (CLNM) in PTMC is approximately 23-64.1%, and the incidence rate of lateral LNM (LLNM) in PTMC is approximately 3.7-44.5%. [4][5][6] Existing guidelines recommend active surveillance for low-risk PTMC, and immediate surgery for those with high-risk features. However, whether prophylactic central lymph node dissection (CLND) should be performed routinely for clinically node-negative (cN0) PTMC patients is still uncertain, because of the lack of substantial evidence showing any survival benefit for these patients.…”

Section: Introductionmentioning

confidence: 99%

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<p>Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients</p>

Song¹,

Yan²,

Qiu³

et al. 2020

CMAR

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To investigate the risk factors for cervical lymph node metastasis (LNM) in papillary thyroid microcarcinoma (PTMC). Patients and Methods: In total, 3686 patients with PTMC who underwent initial surgery in Shanghai Jiao Tong University affiliated Sixth People's Hospital from January 2010 to December 2019 were retrospectively analyzed. Univariate and multivariate analyses were conducted to identify risk factors associated with cervical LNM.

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Section: Discussioncontrasting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

<p>Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients</p>

Song¹,

Yan²,

Qiu³

et al. 2020

CMAR

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show abstract

“…Nomograms have been used in most cancer types in recent years [25][26][27][28][29][30][31][32] , including for ccRCC [33][34][35] . However, there has been a lack of overall evaluations of the developed nomograms, or the variables used for prediction have not been readily available.…”

Section: Discussionmentioning

confidence: 99%

A practical nomogram for predicting cancer-specific survival in patients with clear-cell renal cell carcinoma

Wen

Wang

Bai

et al. 2020

Preprint

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Background: It has limitations in predicting patient cancer-specific survival to use of the traditional American Joint Committee on Cancer (AJCC) staging system alone. Objectives: We aimed to establish and evaluate a comprehensive prognostic nomogram and compare its prognostic value with the AJCC-7th staging system in adults diagnosed with ccRCC.Methods: We used the SEER database to identify 24477 cases of ccRCC between 2010 and 2015. In the development cohort, we used multivariate Cox proportional-hazards analyses to select significant variables, and used R software to establish a nomogram for predicting the 3-year and 5-year cancer-specific survival rates of ccRCC patients. In the development and validation cohorts, we compared our cancer-specific survival model with the AJCC-7th prognosis model to evaluate the performance of the nomogram by calculating the concordance index (C-index), Youden Index, area under the receiver operating characteristic curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI), and performing calibration plotting and decision curve analyses (DCAs). Results: Eleven identified independent prognostic factors were used to establish the nomogram. Age at diagnosis, being unmarried, higher grades, larger tumor size, higher AJCC-7th stage, lymph node metastases, bone metastases, liver metastases, lung metastases, radiotherapy, and no surgery were risk factors for the cancer-specific survival of ccRCC. The C-index, Youden Index, AUC, NRI, IDI, and calibration plots demonstrated the good performance of the nomogram compared to the AJCC-7th staging system. Moreover, the 3-year and 5-year DCA curves showed that the nomogram yielded net benefits that were greater than the traditional AJCC-7th staging system. Conclusion: This study is the first to indicate that married status is an important prognostic parameter in ccRCC. Our results also demonstrate that the developed nomogram can predict cancer-specific survival more accurately than the AJCC-7th staging system alone. The prognostic factors were easily obtained.

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“…22 Park et al and Wang et al exhibited that the tumor sizes > 7 mm and > 5 mm are significant predictive factors for CLNM in patients with cN0 PTMC. 33,34 Otherwise, Yuan et al reported that tumor size is not an independent predictive factor for CLNM in cN0 PTMC. 35 In our study, although the tumor size > 7 mm was not associated with CLNM in cN0 PTMC in multivariate analysis, the tumor sizes of the patient group with pathologic CLNM (n = 41) were significantly larger than those of the patient group without pathologic CLNM (n = 122) ( Fig.…”

Section: Discussionmentioning

confidence: 99%

Select Group of Patients Might Benefit From Prophylactic Central Lymph Node Dissection in Clinically Node Negative Papillary Thyroid Microcarcinoma

Kim

Cho

Gwak

et al. 2020

International Surgery

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Objective: The aim of this study was to identify predictive factors for pathologic central lymph node metastasis (CLNM) in patients with clinically negative CLNM (cN0) papillary thyroid microcarcinoma (PTMC) to suggest a specific group of cN0 PTMC patients who has benefit from prophylactic central lymph node dissection (CLND). Background: PTMC have excellent prognosis, however, 8% have recurrent disease. Recurrence is associated with regional lymph node metastasis. It has been reported that pathologic CLNM is found in 30 to 65% of cN0 PTMC patients. However, prophylactic CLND for cN0 PTMC remains controversial. Methods: We reviewed the records of papillary thyroid carcinoma patients with a tumor size on preoperative ultrasonography (US) of ≤ 10 mm and negative CLNM on preoperative physical examination, US, and positron emission tomography/computed tomography (PET/CT), who underwent total thyroidectomy or thyroid lobectomy with prophylactic CLND between April 2010 and February 2013. In total, 163 patients were included. We evaluated the relationship between preoperatively assessable factors including age, gender, body mass index, preoperative metformin use, primary tumor size through preoperative US, the maximum standardized uptake value (SUVmax) of the primary tumor through preoperative PET/CT, and the bilaterality of the primary tumor and pathologic CLNM. Results: A SUVmax of the primary tumor of > 3 was an independent preoperatively assessable factor predictive of pathologic CLNM in cN0 PTMC patients. Conclusions: Prophylactic CLND might be considered in cN0 PTMC patients with a SUVmax of the primary tumor of > 3 to reduce the risks of residual CLNM and recurrence.

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Nomogram for predicting central lymph node metastasis in papillary thyroid microcarcinoma: A retrospective cohort study of 8668 patients

Cited by 61 publications

References 35 publications

<p>Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients</p>

<p>Clinical Analysis of Risk Factors for Cervical Lymph Node Metastasis in Papillary Thyroid Microcarcinoma: A Retrospective Study of 3686 Patients</p>

A practical nomogram for predicting cancer-specific survival in patients with clear-cell renal cell carcinoma

Select Group of Patients Might Benefit From Prophylactic Central Lymph Node Dissection in Clinically Node Negative Papillary Thyroid Microcarcinoma

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