Clinical detection of "extremely low-risk" follicular thyroid carcinoma: A population-based study of 7304 patients

Laryngoscope Investig Otolaryngol. 2022 Jun 15;7(4):1235-1242. doi: 10.1002/lio2.834. eCollection 2022 Aug.

Abstract

Background: Previous studies have not been consistent in the risk of metastasis in follicular thyroid carcinoma (FTC). Therefore, we conducted a large population study to stratify the risk of distant metastasis in FTC patients using only clinical parameters.

Methods: We extracted FTC patients from The Surveillance, Epidemiology, and End Results (SEER) database and divided them into training and validation cohorts.

Results: The two cohorts consisted of 4913 and 2391 patients, respectively. We developed a nomogram and risk table based on a logistic regression model using algorithm-selected variables. Receiver Operating Characteristic (ROC) analyses showed high discriminatory power in the training and validation cohorts (Area under the curve [AUC] of 0.85 and 0.84, respectively). Extremely low, low, intermediate, and high-risk groups had 0.3%, 1%, 3.5%, and 16.7% risk of distant metastasis, respectively.

Conclusions: Our risk scoring table can separates patients into four risk groups and efficiently detect patients with almost no risk of metastasis.

Keywords: SEER; follicular carcinoma; low‐risk; risk stratification; thyroid; thyroiddistant metastasis.