Background: The aim of this study was to develop and validate a visual nomogram for predicting the risk of bone metastasis (BM) in newly diagnosed thyroid carcinoma (TC) patients.
Methods: The demographics and clinicopathologic variables of TC patients from 2010 to 2015 in the Surveillance, Epidemiology and End Results (SEER) database were retrospectively reviewed. Chi-squared (χ2) test and logistic regression analysis were performed to identify independent risk factors. Based on that, a predictive nomogram was developed and validated for predicting the risk of BM in TC patients. The C-index was used to compute the predictive performance of the nomogram. Calibration curves and decision curve analysis (DCA) were furthermore used to evaluate the clinical value of the nomogram.
Results: According to the inclusion and exclusion criteria, the data of 14,772 patients were used to analyze in our study. After statistical analysis, TC patients with older age, higher T stage, higher N stage, poorly differentiated, follicular thyroid carcinoma (FTC) and black people had a higher risk of BM. We further developed a nomogram with a C-index of 0.925 (95%CI,0.895-0.948) in the training set and 0.842 (95%CI,0.777-0.907) in the validation set. The calibration curves and decision curve analysis (DCA) also demonstrated the reliability and accuracy of the clinical prediction model.
Conclusions: The present study developed a visual nomogram to accurately identify TC patients with high risk of BM, which might help to further provide more individualized clinical decision guidelines.
Keywords: Nomogram; SEER database; Thyroid carcinoma; bone; metastasis; risk factors.