Predictive factors for lung metastasis in pediatric differentiated thyroid cancer: a clinical prediction study

J Pediatr Endocrinol Metab. 2024 Feb 9;37(3):250-259. doi: 10.1515/jpem-2023-0425. Print 2024 Mar 25.

Abstract

Objectives: The objective of this study was to develop and evaluate the efficacy of a nomogram for predicting lung metastasis in pediatric differentiated thyroid cancer.

Methods: The SEER database was utilized to collect a dataset consisting of 1,590 patients who were diagnosed between January 2000 and December 2019. This dataset was subsequently utilized for the purpose of constructing a predictive model. The model was constructed utilizing a multivariate logistic regression analysis, incorporating a combination of least absolute shrinkage feature selection and selection operator regression models. The differentiation and calibration of the model were assessed using the C-index, calibration plot, and ROC curve analysis, respectively. Internal validation was performed using a bootstrap validation technique.

Results: The results of the study revealed that the nomogram incorporated several predictive variables, namely age, T staging, and positive nodes. The C-index had an excellent calibration value of 0.911 (95 % confidence interval: 0.876-0.946), and a notable C-index value of 0.884 was achieved during interval validation. The area under the ROC curve was determined to be 0.890, indicating its practicality and usefulness in this context.

Conclusions: This study has successfully developed a novel nomogram for predicting lung metastasis in children and adolescent patients diagnosed with thyroid cancer. Clinical decision-making can be enhanced by assessing clinicopathological variables that have a significant predictive value for the probability of lung metastasis in this particular population.

Keywords: lung metastasis; nomogram; pediatrics; thyroid cancer.

MeSH terms

  • Adolescent
  • Calibration
  • Child
  • Clinical Decision-Making
  • Databases, Factual
  • Humans
  • Lung Neoplasms*
  • Retrospective Studies
  • Thyroid Neoplasms*