Researchers have developed a new nomogram that can predict lateral lymph node metastasis (LNM) in patients with medullary thyroid cancer (MTC), according to a recent article in Frontiers in Endocrinology.

The nomogram was constructed based on data showing that male sex, higher preoperative calcitonin levels, lateral lymph node involvement, and multifocal lesions are all risk factors for lateral LNM.

“[The] aim of the present study is to establish a multivariate logistic regression model based on neck ultrasound examination, serum [calcitonin] levels and other prognostic factors useful to predict the risk of lateral LNM and identify those patients likely to benefit for lateral neck dissection,” the authors wrote. “This model was further presented as a nomogram and provided specific recommendations on whether patients with MTC should undergo lateral neck dissection.”

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The research team conducted a retrospective study on 82 patients with MTC undergoing surgery in a primary cohort at a single center in China between 2010 and 2018. The validation cohort comprised 42 patients with MTC in 2019.

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The researchers employed preoperative ultrasound to determine the tumor characteristics, and they measured serum calcitonin levels in each patient 1 day, 1 month, 3 months, and 6 months after surgery and every 6 months thereafter.

A nomogram was constructed based on the correlations between serum calcitonin levels, ultrasound results, and baseline patient characteristics, with the aim of predicting LNM in patients with MTC. The team found the nomogram to be superior to the classical method of predicting LNM based on ultrasound or calcitonin levels alone.

The good predictive ability was confirmed in the validation cohort, and the authors hope the new approach will help facilitate communication between surgeons and patients as well as optimize decision-making in terms of lateral neck dissection in these individuals.


Jin L, Zhang X, Ni S, et al. A nomogram to predict lateral lymph node metastases in lateral neck in patients with medullary thyroid cancer. Front Endocrinol. Published online August 16, 2022. doi:10.3389/fendo.2022.902546