■这项研究的目的是开发和验证3-,5-,通过评估LATC患者人群的独立预后预测因子,以及诊断为局部晚期甲状腺癌(LATC)的患者的10年癌症特异性生存率(CSS)和总生存率(OS)。
■人口统计,临床病理特征,治疗,在监测中对2396名LATC患者进行了随访,流行病学,对2004年至2015年的最终结果数据库进行回顾性分析,并根据分期与LATC患者进行比较.我们以7:3的比例将所有LATC患者随机分为训练和验证组。Cox回归分析帮助我们得出LATC患者的独立预后因素。根据这些结果,我们建立并验证了第一个预后列线图和风险分层.
■在我们的研究中,LATC患者的临床资料进行比较,在CSS、OS等相关变量上差异有统计学意义(P<0.05),CSS为82.0%和49.0%,OS分别为70.6%和40.0%,分别。Cox回归分析显示,诊断时的年龄,肿瘤直径,DM的存在,甲状腺外延伸位点,组织学类型,甲状腺切除术范围,放疗状态,LATC患者的放疗和手术的时间顺序与CSS相关,除了上述因素之外,性别,婚姻状况,LATC患者的化疗状态也与OS相关。上述因素的预后预测能力通过Kaplan-Meier存活曲线可视化。CSS和OS的列线图的一致性指数分别为0.933、0.925和0.926(CSS)。0.918、0.909和0.906(OS),分别,和随时间变化的接收器工作特性曲线,曲线下面积,校准曲线和判定曲线分析曲线表明列线图具有良好的判别能力,培训组和验证组的准确性和临床适用性。
■在这些发现中,我们得出结论,T4a和T4bLATC患者的临床信息存在显着差异,我们建立并验证了LATC患者在3年,5年和10年的CSS和OS的第一个预后列线图和风险分层,这将有助于临床医生个性化他们的术后治疗和个性化随访。
UNASSIGNED: The purpose of this research was to develop and validate the first prognostic nomograms for 3-, 5-, and 10-year cancer-specific survival (CSS) and overall survival (OS) in patients diagnosed with locally advanced thyroid cancer (LATC) by evaluating independent predictors of prognosis in a population of LATC patients.
UNASSIGNED: Demographics, clinicopathologic characteristics, treatment, and follow-up of 2396 LATC patients in the surveillance, epidemiology, and end results database from 2004 to 2015 were retrospectively analyzed and compared with patients with LATC according to staging. We randomized all LATC patients into training and validation groups in a 7:3 ratio. Cox regression analyses helped us to derive independent prognostic factors for LATC patients. According to these results, we established and validated the first prognostic nomograms and risk stratification.
UNASSIGNED: In our research, the clinical information of LATC patients was compared and significant differences were found in the relevant variables including CSS and OS (P < 0.05), with CSS of 82.0 % and 49.0 %, and OS of 70.6 % and 40.0 %, respectively. Cox regression analyses showed that age at diagnosis, tumor diameter, presence of DM, extrathyroidal extension sites, histological type, thyroidectomy scope, radiotherapy status, and chronological sequence of radiotherapy and surgery were observably correlated with CSS in LATC patients, and in addition to the above factors, gender, marital status, and chemotherapy status were also observably correlated with OS in LATC patients. The prognostic predictive power of the above factors is visualized by the Kaplan-Meier survival curve. The concordance index of nomograms for CSS and OS were 0.933, 0.925, and 0.926 (CSS), 0.918, 0.909, and 0.906 (OS), respectively, and the time-dependent receiver operating characteristic curve, area under curve, calibration curve and decision curve analysis curve indicate that the nomograms have good discriminatory ability, accuracy and clinical applicability in both the training and validation groups.
UNASSIGNED: In these findings, we drawed a conclusion that there were significant differences in clinical information between patients with T4a and T4b LATC, and we established and validated the first prognostic nomograms and risk stratification of CSS and OS for LATC patients at 3, 5, and 10 years, which will help clinicians to individualize their postoperative treatment and individualized follow-up.