Hui Peng, Minglin Zheng, Jing-Ying Li, Zhaohui Jin
{"title":"利用监测、流行病学和最终结果数据库分析预测分化型甲状腺癌的理想截止年龄。","authors":"Hui Peng, Minglin Zheng, Jing-Ying Li, Zhaohui Jin","doi":"10.21037/tcr-24-247","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>It has been discovered that the prognosis of patients with differentiated thyroid cancer (DTC) correlates with age at initial diagnosis. However, there are disagreements over the optimal cutoff age among the numerous staging and risk stratification criteria, which make it inconsistent to predict the clinical prognosis of specific DTC patients. This study aimed to determine the optimum cutoff age for diagnosis in relation to the clinical outcomes of DTC using data from the Surveillance, Epidemiology and End Results (SEER) database.</p><p><strong>Methods: </strong>The best age cutoff value was determined by the X-tile software. The link between clinical characteristics and cancer-specific survival (CSS) was examined using univariate and multivariate Cox regression models. An additional application of the independent prognostic criteria, such as age stratifications, was applied to construct a nomogram model for predicting the chances of patient survival.</p><p><strong>Results: </strong>The most accurate diagnosis cutoff age for DTC patients was suggested to be 67 years old. The multivariate analysis, using factors determined by univariate analysis, showed that age [>67 years, hazard rate (HR) =5.049, 95% confidence interval (CI): 4.509-5.653, P<0.001], sex (female, HR =0.651, 95% CI: 0.584-0.727, P<0.001), tumor size (>20 and ≤40 mm, HR =2.296, 95% CI: 1.983-2.658, P<0.001; >40 mm, HR =4.976, 95% CI: 4.304-5.752, P<0.001), lymphadenectomy (HR =1.337, 95% CI: 1.186-1.506, P<0.001), distant metastasis (HR =12.166, 95% CI: 10.749-13.769, P<0.001) and surgical treatment (HR =0.173, 95% CI: 0.144-0.210, P<0.001) were independent factors for CSS. Patients in the high-risk group had worse survival rates, and the C-index for the CSS prediction model with age (cutoff of 67) and other independent clinicopathological variables was 0.906.</p><p><strong>Conclusions: </strong>Accordingly, the optimal cutoff age for predicting death from DTC specifically is 67 years old at the time of the initial diagnosis. It might be a more suitable factor when used in risk stratification for patients with DTC.</p>","PeriodicalId":23216,"journal":{"name":"Translational cancer research","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11384314/pdf/","citationCount":"0","resultStr":"{\"title\":\"Analysis of the ideal cutoff age as a predictor of differentiated thyroid cancer using the Surveillance, Epidemiology, and End Results database.\",\"authors\":\"Hui Peng, Minglin Zheng, Jing-Ying Li, Zhaohui Jin\",\"doi\":\"10.21037/tcr-24-247\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>It has been discovered that the prognosis of patients with differentiated thyroid cancer (DTC) correlates with age at initial diagnosis. However, there are disagreements over the optimal cutoff age among the numerous staging and risk stratification criteria, which make it inconsistent to predict the clinical prognosis of specific DTC patients. This study aimed to determine the optimum cutoff age for diagnosis in relation to the clinical outcomes of DTC using data from the Surveillance, Epidemiology and End Results (SEER) database.</p><p><strong>Methods: </strong>The best age cutoff value was determined by the X-tile software. The link between clinical characteristics and cancer-specific survival (CSS) was examined using univariate and multivariate Cox regression models. An additional application of the independent prognostic criteria, such as age stratifications, was applied to construct a nomogram model for predicting the chances of patient survival.</p><p><strong>Results: </strong>The most accurate diagnosis cutoff age for DTC patients was suggested to be 67 years old. The multivariate analysis, using factors determined by univariate analysis, showed that age [>67 years, hazard rate (HR) =5.049, 95% confidence interval (CI): 4.509-5.653, P<0.001], sex (female, HR =0.651, 95% CI: 0.584-0.727, P<0.001), tumor size (>20 and ≤40 mm, HR =2.296, 95% CI: 1.983-2.658, P<0.001; >40 mm, HR =4.976, 95% CI: 4.304-5.752, P<0.001), lymphadenectomy (HR =1.337, 95% CI: 1.186-1.506, P<0.001), distant metastasis (HR =12.166, 95% CI: 10.749-13.769, P<0.001) and surgical treatment (HR =0.173, 95% CI: 0.144-0.210, P<0.001) were independent factors for CSS. Patients in the high-risk group had worse survival rates, and the C-index for the CSS prediction model with age (cutoff of 67) and other independent clinicopathological variables was 0.906.</p><p><strong>Conclusions: </strong>Accordingly, the optimal cutoff age for predicting death from DTC specifically is 67 years old at the time of the initial diagnosis. 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Analysis of the ideal cutoff age as a predictor of differentiated thyroid cancer using the Surveillance, Epidemiology, and End Results database.
Background: It has been discovered that the prognosis of patients with differentiated thyroid cancer (DTC) correlates with age at initial diagnosis. However, there are disagreements over the optimal cutoff age among the numerous staging and risk stratification criteria, which make it inconsistent to predict the clinical prognosis of specific DTC patients. This study aimed to determine the optimum cutoff age for diagnosis in relation to the clinical outcomes of DTC using data from the Surveillance, Epidemiology and End Results (SEER) database.
Methods: The best age cutoff value was determined by the X-tile software. The link between clinical characteristics and cancer-specific survival (CSS) was examined using univariate and multivariate Cox regression models. An additional application of the independent prognostic criteria, such as age stratifications, was applied to construct a nomogram model for predicting the chances of patient survival.
Results: The most accurate diagnosis cutoff age for DTC patients was suggested to be 67 years old. The multivariate analysis, using factors determined by univariate analysis, showed that age [>67 years, hazard rate (HR) =5.049, 95% confidence interval (CI): 4.509-5.653, P<0.001], sex (female, HR =0.651, 95% CI: 0.584-0.727, P<0.001), tumor size (>20 and ≤40 mm, HR =2.296, 95% CI: 1.983-2.658, P<0.001; >40 mm, HR =4.976, 95% CI: 4.304-5.752, P<0.001), lymphadenectomy (HR =1.337, 95% CI: 1.186-1.506, P<0.001), distant metastasis (HR =12.166, 95% CI: 10.749-13.769, P<0.001) and surgical treatment (HR =0.173, 95% CI: 0.144-0.210, P<0.001) were independent factors for CSS. Patients in the high-risk group had worse survival rates, and the C-index for the CSS prediction model with age (cutoff of 67) and other independent clinicopathological variables was 0.906.
Conclusions: Accordingly, the optimal cutoff age for predicting death from DTC specifically is 67 years old at the time of the initial diagnosis. It might be a more suitable factor when used in risk stratification for patients with DTC.
期刊介绍：
Translational Cancer Research (Transl Cancer Res TCR; Print ISSN: 2218-676X; Online ISSN 2219-6803; http://tcr.amegroups.com/) is an Open Access, peer-reviewed journal, indexed in Science Citation Index Expanded (SCIE). TCR publishes laboratory studies of novel therapeutic interventions as well as clinical trials which evaluate new treatment paradigms for cancer; results of novel research investigations which bridge the laboratory and clinical settings including risk assessment, cellular and molecular characterization, prevention, detection, diagnosis and treatment of human cancers with the overall goal of improving the clinical care of cancer patients. The focus of TCR is original, peer-reviewed, science-based research that successfully advances clinical medicine toward the goal of improving patients'' quality of life. The editors and an international advisory group of scientists and clinician-scientists as well as other experts will hold TCR articles to the high-quality standards. We accept Original Articles as well as Review Articles, Editorials and Brief Articles.
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