ArticleOncology letters2025
A clinical feature-based nomogram for the personalized prediction of radioactive iodine therapy outcomes in patients with papillary thyroid carcinoma.
Article in Oncology letters, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
The present study aimed to develop and validate a clinical nomogram for personalized prediction of radioactive iodine (RAI) therapy outcomes in patients with papillary thyroid carcinoma (PTC), addressing the limitations of single-factor predictors such as thyroglobulin (Tg). A retrospective analysis of 1,073 patients with PTC treated with RAI was conducted, with cohorts divided into training (n=751) and validation (n=322) sets. Multivariate logistic regression identified age, sex, tumor subtype, size, metastasis (M) stage and Tg level as independent predictors of non-excellent response at 6 months (all P<0.05), while subtype and Tg level remained significant for 3-year outcomes. The nomogram demonstrated strong discrimination, with AUCs of 0.823 (95% CI, 0.801-0.845) for 6 months and 0.929 (95% CI, 0.915-0.943) for 3 years in the training cohort, and AUCs of 0.804 (95% CI, 0.793-0.820) for 6 months and 0.930 (95% CI, 0.910-0.946) for 3 years in the validation cohort. Calibration was excellent (mean absolute errors, 0.018-0.021). Probability density and K-means clustering confirmed accurate risk stratification. Notably, even without Tg, the model retained predictive power (6 months: AUC, 0.777; 95% CI, 0.725-0.793; 3 years: AUC, 0.897; 95% CI, 0.843-0.909) using factors such as subtype, M stage and lymph node ratio. The suggested nomogram integrates readily available clinical features to personalize risk assessment, aiding tailored follow-up and treatment; it highlights synergistic interactions among secondary factors, offering robust prognostication when Tg is unreliable. This nomogram fills a gap in post-RAI outcome prediction, enhancing precision in PTC management.
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