Abstract 1749P
Background
Surgery is the only way to cure medullary thyroid cancer (MTC), but the management of lateral lymph nodes is controversial especially for patients with cN0+cN1a. Based on preoperative basal calcitonin (Ctn) levels, ultrasound (US) results and baseline characteristics of patients, we created a multivariate logistic regression model to predict lateral lymph nodes metastases (LNM).
Methods
Clinical data of 124 MTC patients underwent initial surgery were collected, at our institution from 2010 to 2019. In chronological order, 82 patients (from 2010 to 2018) were used as the training set to build the model, and 42 patients (from Jan 2019 to Nov 2019) were used as the testing set to validate the model.
Results
In the training group, the results of multivariate analyses indicated male and MTC patients with higher preoperative basal Ctn levels were more likely to have lateral LNM (P = 0.007, 0. 005, respectively). In preoperative neck US, patients whose pathology were pN1b were more commonly found with multifocal lesions and suspected lateral LNM (P = 0.032, 0.002, respectively). The identified risk factors were incorporated into a multivariate logistic regression model to generate the nomogram, which showed good discrimination (C-index = 0.963, 95% CI: 0.9286-0.9972). The calibration curve for prediction of lateral LNM showed good agreement between prediction by nomogram and actual observation. Our model was validated with an excellent result in the testing set (C-index = 0.964, 95% CI: 0.9121 to 1.000).
Conclusions
Higher preoperative basal Ctn level, male, US suspected multifocal lesions and lateral lymph node involvement are risk factors for lateral LNM. Lateral LNM in MTC patients could be objectively and accurately predicted by our model and nomogram.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.