Researchers from China developed an individualized prediction model that could predict the risk of lateral lymph node metastasis (LLNM) in patients with medullary thyroid carcinoma (MTC) and published their results in the International Journal of General Medicine.
“For cN0 MTC patients with a high score according to the model, clinicians should consider the dissection of the lateral cervical lymph node or closer follow-up without [lateral lymph node dissection],” the researchers recommended.
They identified 4 variables as independent predictive factors of LLNM in patients with MTC: male sex (hazard ratio [HR], 2.414; 95% CI, 1.425-4.090, P =.001), multifocality (HR, 2.234; 95% CI, 1.246-4.004; P =.007), extrathyroidal invasion (HR, 8.969; 95% CI, 4.660-17.265; P <.001), and tumor size >10 mm (10 mm<largest diameter≤20 mm: HR, 2.878; 95% CI, 1.367-6.059; P =.005; 20 mm<largest diameter≤40 mm: HR, 3.684; 95% CI, 1.789-7.588; P <.001).
Read more about MTC epidemiology
The authors used these variables to construct the model. The model showed predictive capability, with C-indices of 0.816 and 0.896 in internal and external validation, respectively. Moreover, decision curve analysis further supported a good clinical utility.
“This model might be of great clinical value (follow-up frequency, etc.) and helpful for formulating an operative method for MTC patients,” the researchers said.
To build the model, the researchers analyzed clinicopathological data from patients with MTC retrieved from the Surveillance, Epidemiology, and End Results program (n=924) and the Second Affiliated Hospital of Chongqing Medical University in China (n=22). About 22% of the patients had LLNM. Patients were subdivided into the training set (n=450) and internal validation set (n=474).
The researchers recognized some limitations to the study, including the reduced number of patients in the external validation cohort.
Huang Y, Min Y, Yang G, Wang H, Yin G, Zhang L. Construction and validation of a prediction model for identifying clinical risk factors of lateral lymph node metastasis in medullary thyroid carcinoma. Int J Gen Med. 2022;15:2301-2309. doi:10.2147/IJGM.S353497