Objective: To analyze the prognosis of anaplastic thyroid carcinoma (ATC) based on seer database and establish a Nomogram prediction model. Methods: SEER * Stat software was used to collect 715 cases of ATC diagnosed from 2004 to 2015 in the database. Univariate and multivariate Cox regression analysis, C-index evaluation model and Nomogram prediction model were used to analyze the prognostic factors of ATC patients. Results: Among the 715 ATC cases, 438 cases (61.3 %) were female and 277 cases (38.7 %) were male. Univariate analysis showed that age, AJCC stage, surgery, radiotherapy, chemotherapy, comprehensive treatment, number of resected lymph nodes, number of positive lymph nodes, and tumor size were the factors affecting the survival and prognosis of patients with ATC (P＜0.05). Multivariate analysis showed that age ≥45 years old, T4b stage, M1 stage, tumor ≥65 mm, no lymph node resection, tumor recurrence and multiple malignant tumors were independent risk factors for poor prognosis in ATC patients, and surgery, chemotherapy and radiotherapy were independent protective factors (P＜0.05). According to KM survival analysis, the prognosis of ATC patients was poor, and the survival rate of patients with advanced ATC was very low, with a 1-year survival rate of about 2 %. Conclusion: For ATC patients confined to the thyroid gland, it is recommended to actively receive treatment, which can prolong the survival period, but for patients with advanced ATC, the current treatment plan does not effectively prolong the survival period, so for such patients, supportive care or hospice care is considered as an alternative.
BAI Jinyu
,
WANG Cuifeng
. Prognostic analysis and Nomogram prediction model of anaplastic thyroid carcinoma based on seer database[J]. Journal of Baotou Medical College, 2023
, 39(8)
: 37
-43
.
DOI: 10.16833/j.cnki.jbmc.2023.08.008
[1] SiegelL,et al. Cancer statistics,2018[J].CA Cancer J Clin,2018,68(1):7-30.
[2] GillilandD,et al. Prognostic factors for thyroid carcinoma.A population-based study of 15,698 cases from the Surveillance,Epidemiology and End Results (SEER) program 1973-1991[J].Cancer,1997,79(3):564-573.
[3] Sugitain I,et al. Prognostic factors and treatment outcomes for anaplastic thyroid carcinoma: ATC research consortium of Japan cohort study of 677 patients[J].World J Surg,2012,36(6):1247-1254.
[4] Kebebew E,et al. Anaplastic thyroid carcinoma[J].Cancer,2005,103(7):1330-1335.
[5] HeY,et al. LKB1 loss at transcriptional level promotes tumor malignancy and poor patient outcomes in colorectal cancer[J].Ann Surg Oncol,2014,21(4):703-710.
[6] Orita Y,et al. Prospective application of our novel prognostic index in the treatment of anaplastic thyroid carcinoma[J].Surgery,2011,150(6):1212-1219.
[7] WatkinsonC,et al. The British Thyroid Association guidelines for the management of thyroid cancer in adults[J].Nucl Med Commun,2004,25(9):897-900.
[8] PierieP,et al. The effect of surgery and radiotherapy on outcome of anaplastic thyroid carcinoma[J].Ann Surg Oncol,2002,9(1):57-64.
[9] GuiW,et al. Development and validation of a prognostic nomogram to predict overall survival and cancer-specific survival for patients with anaplastic thyroid carcinoma[J].PeerJ,2020,8:9173.
[10] AequeA,et al. Updates on the management of thyroid cancer[J].Horm Metab,2020,52(8):562-577.
[11] Onada N,et al. Evaluation of the 8th edition TNM classification for anaplastic thyroid carcinoma[J].Cancers,2020,12(3):552.
[12] Liu F,Wang SF,Ye ZH,et al. Prediction of lung metastases in thyroid cancer using machine learning based on SEER database[J].Cancer Med,2022,11(12):2503-2515.
[13] HundahlA,FlemingI D,et al. A National Cancer Data Base report on 53,856 cases of thyroid carcinoma treated in the U.S.,1985-1995[see commetns][J].Cancer,1998,83(12):2638-2648.
[14] ShahaA. Implications of prognostic factors and risk groups in the management of differentiated thyroid cancer[J].Laryngoscope,2004,114(3):393-402.
[15] 武元元,王军,刘勤江,等. 甲状腺未分化癌的预后因素分析及治疗决策[J].中国癌症杂志,2021,31(3):212-220.
[16] Haddad R I,Naer C,Bischoher L,et al. NCCN guidelines insights: thyroid carcinoma,version 2.2018[J].J Natl Compr Canc Netw,2018,16 (12): 1429-1440.
[17] Passler C,Scheuba C,Prager G,et al. Niederle B 1999 anaplastic (undifferentiated) thyroid carcinoma(ATC)[J].Langenbecks Arch Surg,1999,384(3):284-293.
[18] Feng C,Zai H Y,Jing W,et al. Survival and analysis of prognostic factors for hepatoblastoma: based on SEER database[J].Ann Transl Med,2019,7(20):555.
[19] Clark OH. Predictors of thyroid tumor aggressiveness[J].West J Med,1996,165(3):131-138.
[20] Mciver B,Hay ID,et al. Anaplastic thyroid carcinoma: a 50-year experience at a single institution[J].Surgery,2001,130(6):1028-1034.
[21] Paunovic IR,et al. Survival and prognostic factors of anaplastic thyroid carcinoma[J].Acta Chir Belg,2015,115:62-67.
[22] Sun CZ,et al. Influence of risk grouping on therapeutic decisions in patients with anaplastic thyroid carcinoma[J].Eur Arch Otorhinolaryngol,2015,272(4):985-993.
[23] Keith C Bible,et al. 2021 American Thyroid Association Guidelines for management of patients with anaplastic thyroid cancer[J].Thyroid,2021,3(10):334-347.
