Chunwang Huang1,2, Shuzhen Cong2,3, Ting Liang4, Zhanwu Feng2, Kehong Gan2, Ruili Zhou2, Yuping Guo2, Siwei Luo2, Kunming Liang5, Quanshi Wang1. 1. PET Center, Nanfang Hospital, Southern Medical University, Guangzhou, China. 2. Department of Ultrasound, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. 3. The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China. 4. Department of Ultrasound, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China. 5. Department of Pathology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Abstract
BACKGROUND: Preoperative prediction of central lymph node metastasis (CLNM) holds significant value in determining a patient's suitability for surgical resection and the need for adjuvant treatment, thereby contributing to better therapeutic strategies. This study aimed to build and confirm a nomogram that integrates ultrasound (US) characteristics with clinical features to predict CLNM in patients with papillary thyroid carcinoma (PTC) preoperatively. METHODS: The prediction model was set up with a training dataset that included 512 patients with histopathologically confirmed PTC. The least absolute shrinkage and selection operator (LASSO) regression method was applied to select US features in the development cohort. The patients' US characteristics and clinical features were incorporated into a multivariate logistic regression analysis to develop the nomogram. The clinical feasibility, calibration, and discriminatory ability of the nomogram were evaluated in an independent validation cohort of 306 patients. RESULTS: Age, sex, tumor size, multiple tumors, and US-based CLNM status were included as independent predictors in the personalized nomogram. The nomogram showed good calibration and discrimination in the training and validation datasets. The addition of the BRAF V600E mutation status did not improve the performance of the nomogram. The decision curve analysis showed the nomogram to have clinical feasibility. CONCLUSIONS: A nomogram that integrates US characteristics with patients' clinical features was built. This US-based nomogram can be expediently applied to promote the personalized preoperative prediction of CLNM and to develop surgical strategies, such as tailored central compartment neck dissection, in patients with PTC. 2020 Gland Surgery. All rights reserved.
BACKGROUND: Preoperative prediction of central lymph node metastasis (CLNM) holds significant value in determining a patient's suitability for surgical resection and the need for adjuvant treatment, thereby contributing to better therapeutic strategies. This study aimed to build and confirm a nomogram that integrates ultrasound (US) characteristics with clinical features to predict CLNM in patients with papillary thyroid carcinoma (PTC) preoperatively. METHODS: The prediction model was set up with a training dataset that included 512 patients with histopathologically confirmed PTC. The least absolute shrinkage and selection operator (LASSO) regression method was applied to select US features in the development cohort. The patients' US characteristics and clinical features were incorporated into a multivariate logistic regression analysis to develop the nomogram. The clinical feasibility, calibration, and discriminatory ability of the nomogram were evaluated in an independent validation cohort of 306 patients. RESULTS: Age, sex, tumor size, multiple tumors, and US-based CLNM status were included as independent predictors in the personalized nomogram. The nomogram showed good calibration and discrimination in the training and validation datasets. The addition of the BRAF V600E mutation status did not improve the performance of the nomogram. The decision curve analysis showed the nomogram to have clinical feasibility. CONCLUSIONS: A nomogram that integrates US characteristics with patients' clinical features was built. This US-based nomogram can be expediently applied to promote the personalized preoperative prediction of CLNM and to develop surgical strategies, such as tailored central compartment neck dissection, in patients with PTC. 2020 Gland Surgery. All rights reserved.
Authors: Seo Ki Kim; Young Jun Chai; Inhye Park; Jung-Woo Woo; Jun Ho Lee; Kyu Eun Lee; Jun-Ho Choe; Jung-Han Kim; Jee Soo Kim Journal: J Surg Oncol Date: 2016-11-18 Impact factor: 3.454
Authors: Mamoona T Khokhar; Kristopher M Day; Rohit B Sangal; Nigar N Ahmedli; Latha R Pisharodi; Michael D Beland; Jack M Monchik Journal: Thyroid Date: 2015-11-20 Impact factor: 6.568