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Nomogram Including Elastography for Prediction of Contralateral Central Lymph Node Metastasis in Solitary Papillary Thyroid Carcinoma Preoperatively
BACKGROUND: It is controversial whether contralateral prophylactic central neck dissection (PCND) should be performed for patients with solitary and clinical lymph node negative (cN(0)) papillary thyroid carcinoma (PTC) although routine ipsilateral PCND is required. OBJECTIVE: The aim of this study...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605913/ https://www.ncbi.nlm.nih.gov/pubmed/33149684 http://dx.doi.org/10.2147/CMAR.S278382 |
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author | Li, Ning He, Ju-hua Song, Chao Yang, Li-chun Zhang, Hong-jiang Li, Zhi-hai |
author_facet | Li, Ning He, Ju-hua Song, Chao Yang, Li-chun Zhang, Hong-jiang Li, Zhi-hai |
author_sort | Li, Ning |
collection | PubMed |
description | BACKGROUND: It is controversial whether contralateral prophylactic central neck dissection (PCND) should be performed for patients with solitary and clinical lymph node negative (cN(0)) papillary thyroid carcinoma (PTC) although routine ipsilateral PCND is required. OBJECTIVE: The aim of this study was to develop an improved nomogram including clinical features, ultrasound, and acoustic radiation force impulse (ARFI) elastography for the prediction of contralateral central lymph node metastasis (CLNM) in patients with solitary and cN(0) PTC in the preoperative period. MATERIALS AND METHODS: A total of 340 patients were retrospectively included as the training cohort and 170 patients as the external validation cohort. Patients were grouped according to the pathological results of contralateral CLNM. The association between the clinical characteristics, ultrasound, and ARFI elastography and the risk for contralateral CLNM were analyzed. A nomogram was established based on the result of multivariable logistic analysis to predict the risk of contralateral CLNM, which was assessed by internal and external validation. RESULTS: CLNM was found in 213 patients (41.8%), among whom 142 (27.8%) had ipsilateral CLNM and 95 (18.6%) had contralateral CLNM (including 68 (13.3%) with bilateral CLNM). Multivariable analysis revealed that patients with younger age, male gender, larger tumor size, closer distance from the capsule, microcalcification, and larger SWV(mean) were independent predictors associated with the contralateral CLNM (P < 0.05), which was served as the basis of the nomogram. It showed good discrimination (C-index: 0.856) and calibration (χ(2) = 9.028, P = 0.340, Hosmer–Lemeshow test) in the training cohort, and good discrimination was maintained in the external validation cohort (C-index: 0.792). CONCLUSION: The nomogram utilizing the features of ultrasound combined with ARFI elastography in preoperatively predicting the risk of contralateral CLNM in patients with solitary and cN(0) PTC was established, which showed superior performance both in internal and external validation. |
format | Online Article Text |
id | pubmed-7605913 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-76059132020-11-03 Nomogram Including Elastography for Prediction of Contralateral Central Lymph Node Metastasis in Solitary Papillary Thyroid Carcinoma Preoperatively Li, Ning He, Ju-hua Song, Chao Yang, Li-chun Zhang, Hong-jiang Li, Zhi-hai Cancer Manag Res Original Research BACKGROUND: It is controversial whether contralateral prophylactic central neck dissection (PCND) should be performed for patients with solitary and clinical lymph node negative (cN(0)) papillary thyroid carcinoma (PTC) although routine ipsilateral PCND is required. OBJECTIVE: The aim of this study was to develop an improved nomogram including clinical features, ultrasound, and acoustic radiation force impulse (ARFI) elastography for the prediction of contralateral central lymph node metastasis (CLNM) in patients with solitary and cN(0) PTC in the preoperative period. MATERIALS AND METHODS: A total of 340 patients were retrospectively included as the training cohort and 170 patients as the external validation cohort. Patients were grouped according to the pathological results of contralateral CLNM. The association between the clinical characteristics, ultrasound, and ARFI elastography and the risk for contralateral CLNM were analyzed. A nomogram was established based on the result of multivariable logistic analysis to predict the risk of contralateral CLNM, which was assessed by internal and external validation. RESULTS: CLNM was found in 213 patients (41.8%), among whom 142 (27.8%) had ipsilateral CLNM and 95 (18.6%) had contralateral CLNM (including 68 (13.3%) with bilateral CLNM). Multivariable analysis revealed that patients with younger age, male gender, larger tumor size, closer distance from the capsule, microcalcification, and larger SWV(mean) were independent predictors associated with the contralateral CLNM (P < 0.05), which was served as the basis of the nomogram. It showed good discrimination (C-index: 0.856) and calibration (χ(2) = 9.028, P = 0.340, Hosmer–Lemeshow test) in the training cohort, and good discrimination was maintained in the external validation cohort (C-index: 0.792). CONCLUSION: The nomogram utilizing the features of ultrasound combined with ARFI elastography in preoperatively predicting the risk of contralateral CLNM in patients with solitary and cN(0) PTC was established, which showed superior performance both in internal and external validation. Dove 2020-10-29 /pmc/articles/PMC7605913/ /pubmed/33149684 http://dx.doi.org/10.2147/CMAR.S278382 Text en © 2020 Li et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Li, Ning He, Ju-hua Song, Chao Yang, Li-chun Zhang, Hong-jiang Li, Zhi-hai Nomogram Including Elastography for Prediction of Contralateral Central Lymph Node Metastasis in Solitary Papillary Thyroid Carcinoma Preoperatively |
title | Nomogram Including Elastography for Prediction of Contralateral Central Lymph Node Metastasis in Solitary Papillary Thyroid Carcinoma Preoperatively |
title_full | Nomogram Including Elastography for Prediction of Contralateral Central Lymph Node Metastasis in Solitary Papillary Thyroid Carcinoma Preoperatively |
title_fullStr | Nomogram Including Elastography for Prediction of Contralateral Central Lymph Node Metastasis in Solitary Papillary Thyroid Carcinoma Preoperatively |
title_full_unstemmed | Nomogram Including Elastography for Prediction of Contralateral Central Lymph Node Metastasis in Solitary Papillary Thyroid Carcinoma Preoperatively |
title_short | Nomogram Including Elastography for Prediction of Contralateral Central Lymph Node Metastasis in Solitary Papillary Thyroid Carcinoma Preoperatively |
title_sort | nomogram including elastography for prediction of contralateral central lymph node metastasis in solitary papillary thyroid carcinoma preoperatively |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605913/ https://www.ncbi.nlm.nih.gov/pubmed/33149684 http://dx.doi.org/10.2147/CMAR.S278382 |
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