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ORIGINAL RESEARCH article

Front. Endocrinol.
Sec. Thyroid Endocrinology
Volume 15 - 2024 | doi: 10.3389/fendo.2024.1419125
This article is part of the Research Topic Papillary Thyroid Cancer: Prognostic Factors and Risk Assessment View all 16 articles

Rethinking on prognosis model of differentiated thyroid carcinoma

Provisionally accepted
Liang He Liang He Jingzhe Xiang Jingzhe Xiang Hao Zhang Hao Zhang *
  • Department of Thyroid Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China

The final, formatted version of the article will be published soon.

    The prediction efficiency of long-term cancer-specific survival (CSS) to guide the treatment of differentiated thyroid cancer (DTC) patients is still unsatisfactory. We need to refine a system more accurately correlate with survival.Methods: This is a retrospective study using the Surveillance, Epidemiology and End Results (SEER) database, which included patients who underwent surgical treatment and diagnosed with DTC from 2004 to 2020. Patients were divided into training cohort (2004-2015) and validation cohort (2016-2020). Decision tree methodology was used to build the model in training cohort. The newly identified groups were verified in validation cohort.Results：52917 and 48896 patients with DTC were included in training cohort and validation cohort. Decision tree classification of DTC patients was consisted of five categorical variables which in order of importance were the following: M categories, age, extrathyroidal extension, tumor size and N categories. Then we identified 5 TNM groups with similar within-group CSS. More patients were classified as stage I, and the number of stage IV decreased significantly. The new system has a higher proportions of variance explained (PVE) (5.04%) and lower Akaike information criterion (AIC) (18331.906) than the 8 th TNM staging system (PVE for 4.11% and AIC for 18692.282). In validation cohort, the new system also showed better discrimination on survival.The new system for DTC appeared to be more accurate on distinguishing stages according to risk of mortality, which provided more accurate risk stratifications and potential treatment selections.

    Keywords: Differentiated thyroid cancer, Cancer-specific survival, Decision tree methodology, Proportions of variance explained, TNM staging system

    Received: 17 Apr 2024; Accepted: 05 Sep 2024.

    Copyright: © 2024 He, Xiang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hao Zhang, Department of Thyroid Surgery, The First Affiliated Hospital of China Medical University, Shenyang, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.