Development and validation of a nomogram for predicting 5-year progression-free survival probability in differentiated thyroid cancer patients with lung metastases
4 affiliations
- 1Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao
- 2Department of Emergency Medicine, The Affiliated Hospital of Qingdao University, Qingdao
- 3Department of Radiology, Qingdao Women and Children’s Hospital, Qingdao
- 4Department of Nuclear Medicine, Shanghai Tenth People’s Hospital, Tongji University School of Medicine
Abstract
Background and objective: Progressive disease (PD) in differentiated thyroid cancer patients with lung metastases (DTC-LM) poses a significant clinical challenge, yet reliable predictive tools remain limited. This study aimed to develop and validate a nomogram for individualized prediction of 5-year progression-free survival (PFS) probability in DTC-LM patients.
Methods: This retrospective study included 284 DTC-LM patients from two institutions, divided into a training cohort (Qingdao cohort, n = 184) and an external validation cohort (Shanghai cohort, n = 100). Patients were classified as having PD or non-PD (NPD) at final follow-up. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent predictors of PD. A nomogram based on the multivariable Cox model was developed to estimate 5-year PFS probability. Model performance was evaluated using the C-index, calibration curves, and decision curve analysis (DCA).
Results: Multivariate analysis identified age upon diagnosis (≥55 years), tumor size, pre-ablation stimulated thyroglobulin (Ps-Tg ≥528.5 ng/mL), and initial RAI avidity status as independent predictors of PD. The 5-year PFS probability nomogram demonstrated excellent discrimination, with a C-index of 0.874 in the training cohort and 0.769 in the external validation cohort. Calibration curves showed good agreement between predicted and observed outcomes, and DCA confirmed favorable clinical net benefit.
Conclusion: This nomogram incorporating four readily available clinical variables showed good discrimination for predicting 5-year PFS probability in DTC-LM patients and may facilitate preliminary risk stratification and timely therapeutic decision-making.
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BibTeX
@article{wang2026development,
title = {{Development and validation of a nomogram for predicting 5-year progression-free survival probability in differentiated thyroid cancer patients with lung metastases}},
author = {Congcong Wang and Xiaonian Zhang and Yingying Zhang and Jingshuang Liu and Guohua Qin and Peihang Han and Yutian Li and Renfei Wang and Xufu Wang},
journal = {Frontiers in Endocrinology},
year = {2026},
month = oct,
doi = {10.3389/fendo.2026.1938835},
url = {https://www.frontiersin.org/articles/10.3389/fendo.2026.1938835/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Development and validation of a nomogram for predicting 5-year progression-free survival probability in differentiated thyroid cancer patients with lung metastases
AU - Congcong Wang
AU - Xiaonian Zhang
AU - Yingying Zhang
AU - Jingshuang Liu
AU - Guohua Qin
AU - Peihang Han
AU - Yutian Li
AU - Renfei Wang
AU - Xufu Wang
PY - 2026
DA - 2026/10/21
JO - Frontiers in Endocrinology
DO - 10.3389/fendo.2026.1938835
UR - https://www.frontiersin.org/articles/10.3389/fendo.2026.1938835/full
AB - Background and objective: Progressive disease (PD) in differentiated thyroid cancer patients with lung metastases (DTC-LM) poses a significant clinical challenge, yet reliable predictive tools remain limited. This study aimed to develop and validate a nomogram for individualized prediction of 5-year progression-free survival (PFS) probability in DTC-LM patients. Methods: This retrospective study included 284 DTC-LM patients from two institutions, divided into a training cohort (Qingdao cohort, n = 184) and an external validation cohort (Shanghai cohort, n = 100). Patients were classified as having PD or non-PD (NPD) at final follow-up. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent predictors of PD. A nomogram based on the multivariable Cox model was developed to estimate 5-year PFS probability. Model performance was evaluated using the C-index, calibration curves, and decision curve analysis (DCA). Results: Multivariate analysis identified age upon diagnosis (≥55 years), tumor size, pre-ablation stimulated thyroglobulin (Ps-Tg ≥528.5 ng/mL), and initial RAI avidity status as independent predictors of PD. The 5-year PFS probability nomogram demonstrated excellent discrimination, with a C-index of 0.874 in the training cohort and 0.769 in the external validation cohort. Calibration curves showed good agreement between predicted and observed outcomes, and DCA confirmed favorable clinical net benefit. Conclusion: This nomogram incorporating four readily available clinical variables showed good discrimination for predicting 5-year PFS probability in DTC-LM patients and may facilitate preliminary risk stratification and timely therapeutic decision-making.
SN - 1664-2392
ER -