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Scoring System for Mortality in Patients Diagnosed with and Treated Surgically for Differentiated Thyroid Carcinoma with a 20-Year Follow-Up.

López-Bru D, Palazón-Bru A, Folgado-de la Rosa DM, Gil-Guillén VF - PLoS ONE (2015)

Bottom Line: A Cox multivariate regression model was constructed to determine which variables at diagnosis were associated with mortality.This study provides a practical clinical tool giving a simple and rapid indication (via a mobile application) of which patients with DTC are at risk of dying in 5, 10, 15 or 20 years.Nonetheless, caution should be exercised until validation studies have corroborated our results.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, General University Hospital, Elda, Alicante, Spain.

ABSTRACT

Background: Differentiated thyroid carcinoma (DTC) is associated with an increased mortality. Few studies have constructed predictive models of all-cause mortality with a high discriminating power for patients with this disease that would enable us to determine which patients are more likely to die.

Objective: To construct a predictive model of all-cause mortality at 5, 10, 15 and 20 years for patients diagnosed with and treated surgically for DTC for use as a mobile application.

Design: We undertook a retrospective cohort study using data from 1984 to 2013.

Setting: All patients diagnosed with and treated surgically for DTC at a general university hospital covering a population of around 200,000 inhabitants in Spain.

Participants: The study involved 201 patients diagnosed with and treated surgically for DTC (174, papillary; 27, follicular).

Exposures: Age, gender, town, family history, type of surgery, type of cancer, histological subtype, microcarcinoma, multicentricity, TNM staging system, diagnostic stage, permanent post-operative complications, local and regional tumor persistence, distant metastasis, and radioiodine therapy.

Main outcome measure: All-cause mortality.

Methods: A Cox multivariate regression model was constructed to determine which variables at diagnosis were associated with mortality. Using the model a risk table was constructed based on the sum of all points to estimate the likelihood of death. This was then incorporated into a mobile application.

Results: The mean follow-up was 8.8±6.7 years. All-cause mortality was 12.9% (95% confidence interval [CI]: 8.3-17.6%). Predictive variables: older age, local tumor persistence and distant metastasis. The area under the ROC curve was 0.81 (95% CI: 0.72-0.91, p<0.001).

Conclusion: This study provides a practical clinical tool giving a simple and rapid indication (via a mobile application) of which patients with DTC are at risk of dying in 5, 10, 15 or 20 years. Nonetheless, caution should be exercised until validation studies have corroborated our results.

No MeSH data available.


Related in: MedlinePlus

Area under the ROC curve of the predictive model.ROC, receiver operating characteristic; AUC, area under the curve; CI, confidence interval.
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pone.0128620.g002: Area under the ROC curve of the predictive model.ROC, receiver operating characteristic; AUC, area under the curve; CI, confidence interval.

Mentions: The multivariate model (Table 1) provided the predictive scale for mortality (Fig 1); this figure shows the scoring system with the risk groups for predicting mortality. This predictive model has an AUC (Fig 2) of 0.81 (95% CI: 0.72–0.91, p<0.001). The cut points (optimum, 9; confirmation, 11; discard, 3) and their indicators of validity (sensitivity and specificity), yield (PPV and NPV) and usefulness (PLR and NLR) are shown in Table 2.


Scoring System for Mortality in Patients Diagnosed with and Treated Surgically for Differentiated Thyroid Carcinoma with a 20-Year Follow-Up.

López-Bru D, Palazón-Bru A, Folgado-de la Rosa DM, Gil-Guillén VF - PLoS ONE (2015)

Area under the ROC curve of the predictive model.ROC, receiver operating characteristic; AUC, area under the curve; CI, confidence interval.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4482660&req=5

pone.0128620.g002: Area under the ROC curve of the predictive model.ROC, receiver operating characteristic; AUC, area under the curve; CI, confidence interval.
Mentions: The multivariate model (Table 1) provided the predictive scale for mortality (Fig 1); this figure shows the scoring system with the risk groups for predicting mortality. This predictive model has an AUC (Fig 2) of 0.81 (95% CI: 0.72–0.91, p<0.001). The cut points (optimum, 9; confirmation, 11; discard, 3) and their indicators of validity (sensitivity and specificity), yield (PPV and NPV) and usefulness (PLR and NLR) are shown in Table 2.

Bottom Line: A Cox multivariate regression model was constructed to determine which variables at diagnosis were associated with mortality.This study provides a practical clinical tool giving a simple and rapid indication (via a mobile application) of which patients with DTC are at risk of dying in 5, 10, 15 or 20 years.Nonetheless, caution should be exercised until validation studies have corroborated our results.

View Article: PubMed Central - PubMed

Affiliation: Department of Otorhinolaryngology, General University Hospital, Elda, Alicante, Spain.

ABSTRACT

Background: Differentiated thyroid carcinoma (DTC) is associated with an increased mortality. Few studies have constructed predictive models of all-cause mortality with a high discriminating power for patients with this disease that would enable us to determine which patients are more likely to die.

Objective: To construct a predictive model of all-cause mortality at 5, 10, 15 and 20 years for patients diagnosed with and treated surgically for DTC for use as a mobile application.

Design: We undertook a retrospective cohort study using data from 1984 to 2013.

Setting: All patients diagnosed with and treated surgically for DTC at a general university hospital covering a population of around 200,000 inhabitants in Spain.

Participants: The study involved 201 patients diagnosed with and treated surgically for DTC (174, papillary; 27, follicular).

Exposures: Age, gender, town, family history, type of surgery, type of cancer, histological subtype, microcarcinoma, multicentricity, TNM staging system, diagnostic stage, permanent post-operative complications, local and regional tumor persistence, distant metastasis, and radioiodine therapy.

Main outcome measure: All-cause mortality.

Methods: A Cox multivariate regression model was constructed to determine which variables at diagnosis were associated with mortality. Using the model a risk table was constructed based on the sum of all points to estimate the likelihood of death. This was then incorporated into a mobile application.

Results: The mean follow-up was 8.8±6.7 years. All-cause mortality was 12.9% (95% confidence interval [CI]: 8.3-17.6%). Predictive variables: older age, local tumor persistence and distant metastasis. The area under the ROC curve was 0.81 (95% CI: 0.72-0.91, p<0.001).

Conclusion: This study provides a practical clinical tool giving a simple and rapid indication (via a mobile application) of which patients with DTC are at risk of dying in 5, 10, 15 or 20 years. Nonetheless, caution should be exercised until validation studies have corroborated our results.

No MeSH data available.


Related in: MedlinePlus