Postoperative nomogram for predicting cancer-specific mortality in medullary thyroid cancer Journal Article
| Authors: | Ho, A. S.; Wang, L.; Palmer, F. L.; Yu, C.; Toset, A.; Patel, S.; Kattan, M. W.; Tuttle, R. M.; Ganly, I. |
| Article Title: | Postoperative nomogram for predicting cancer-specific mortality in medullary thyroid cancer |
| Abstract: | Background: Medullary thyroid cancer (MTC) is a rare thyroid cancer accounting for 5 % of all thyroid malignancies. The purpose of our study was to design a predictive nomogram for cancer-specific mortality (CSM) utilizing clinical, pathological, and biochemical variables in patients with MTC. Methods: MTC patients managed entirely at Memorial Sloan-Kettering Cancer Center between 1986 and 2010 were identified. Patient, tumor, and treatment characteristics were recorded, and variables predictive of CSM were identified by univariable analyses. A multivariable competing risk model was then built to predict the 10-year cancer specific mortality of MTC. All predictors of interest were added in the starting full model before selection, including age, gender, pre- and postoperative serum calcitonin, pre- and postoperative CEA, RET mutation status, perivascular invasion, margin status, pathologic T status, pathologic N status, and M status. Stepdown method was used in model selection to choose predictive variables. Results: Of 249 MTC patients, 22.5 % (56/249) died from MTC, whereas 6.4 % (16/249) died secondary to other causes. Mean follow-up period was 87 ± 67 months. The seven variables with the highest predictive accuracy for cancer specific mortality included age, gender, postoperative calcitonin, perivascular invasion, pathologic T status, pathologic N status, and M status. These variables were used to create the final nomogram. Discrimination from the final nomogram was measured at 0.77 with appropriate calibration. Conclusions: We describe the first nomogram that estimates cause-specific mortality in individual patients with MTC. This predictive nomogram will facilitate patient counseling in terms of prognosis and subsequent clinical follow up. © 2014, Society of Surgical Oncology. |
| Keywords: | adult; middle aged; major clinical study; postoperative period; cancer patient; follow up; carcinoembryonic antigen; calibration; calcitonin; cancer mortality; cause of death; thyroidectomy; surgical mortality; disease specific survival; nomogram; patient counseling; model; predictive value; thyroid medullary carcinoma; calcitonin blood level; cancer prognosis; measurement accuracy; human; male; female; article |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 22 |
| Issue: | 8 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2015-08-01 |
| Start Page: | 2700 |
| End Page: | 2706 |
| Language: | English |
| DOI: | 10.1245/s10434-014-4208-2 |
| PROVIDER: | scopus |
| PUBMED: | 25366585 |
| PMCID: | PMC4986610 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2015 -- Source: Scopus |
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