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Nomogram predictive of 10-year cause-specific mortality in differentiated thyroid cancer.
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Nomogram predictive of 10-year cause-specific mortality in differentiated thyroid cancer.
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Title
Nomogram
predictive
of
10-year
cause-specific
mortality
in
differentiated
thyroid
cancer
.
Creator.PersonalName
Park
,
Renee
E
.
Thesis.Degree
M.P.H.
Thesis.Major
Public Health
Thesis.DateDegreeAwarded
May
2009
Institution
Oregon Health & Science University
School
School of Medicine
Department
Dept. of Public Health and Preventive Medicine
Thesis.Advisor/Mentor
Gross, Neil D.
Thesis.Chair
Mori, Motomi
Thesis.Committee
Austin, Donald F.
Subject.MeSH
Thyroid Neoplasms
Mortality
Nomograms
Call Number
Q171 P2357 2009
Description.Abstract
Background
: The
application
of
appropriate
treatment
for
differentiated
thyroid
cancer
(DTC)
,
including
extent
of
surgery
and
adjuvant
therapy
,
is
predicated
on
accurate
patient
risk
stratification
.
Although
risk
factors
for
mortality
from
DTC
have been
well-described
on the
population
level
, they have not been
unified
into a
single
algorithm
to
predict
individual
risk
. This
study
aimed
to
develop
a
nomogram
for
estimating
10-year
cause
specific
mortality
in
well
to
poorly
DTC
.
Methods
: A
historical
cohort
of
9,654
patients
with
DTC
recorded
in the
SEER
national
cancer
registry
from
1985
to
1995
was
used
to
identify
and
quantify
all
clinically
relevant
predictors
of
10-year
cancer-specific
mortality
.
Multivariable
Cox
proportional
hazards
regression
was
used
for
model
selection
and
nomogram
development
. The
predictive
accuracy
of the
nomogram
was
internally
validated
using
bootstrapping
methods
and
quantitated
using
the
area
under
the
receiver
operating
characteristic
curve
(AUC)
.
Results
:
Ten-year
cause-specific
mortality
was
3.3%
.
Significant
predictors
of
mortality
included
age
,
gender
,
extracapsular
extension
,
tumor
size
,
nodal
status
,
distant
metastasis
and
histology
. The
nomogram
successfully
estimated
an
individualized
risk
of
mortality
from
DTC
by
assigning
relative
weights
to
each
of these
risk
factors
.
Model
discrimination
was
excellent
with an
AUC
of
0.93
, with
good
calibration
.
Discussion
&
Conclusions
: This
nomogram
is
the
first
prognostic
model
developed
to
predict
the
likelihood
of
mortality
for an
individual
patient
with
DTC
.
More
accurate
patient
risk
stratification
using
the
nomogram
has
practical
applications
for
clinical
care
and
research
.
Language
eng
Type
Text
Format.Use
Needs Adobe Acrobat to view
Format.FileSize
1479805 Bytes
OCLC number
420534095
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