scholarly journals A Five-Gene Prognostic Nomogram Predicting Disease-Free Survival of Differentiated Thyroid Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-15
Author(s):  
Pan Ruchong ◽  
Tang Haiping ◽  
Wang Xiang

Background. Differentiated thyroid cancer (DTC) is the most common type of thyroid tumor with a high recurrence rate. Here, we developed a nomogram to effectively predict postoperative disease-free survival (DFS) in DTC patients. Methods. The mRNA expressions and clinical data of DTC patients were downloaded from the Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) database. Seventy percent of patients were randomly selected as the training dataset, and thirty percent of patients were classified into the testing dataset. Multivariate Cox regression analysis was adopted to establish a nomogram to predict 1-year, 3-year, and 5-year DFS rate of DTC patients. Results. A five-gene signature comprised of TENM1, FN1, APOD, F12, and BTNL8 genes was established to predict the DFS rate of DTC patients. Results from the concordance index (C-index), area under curve (AUC), and calibration curve showed that both the training dataset and the testing dataset exhibited good prediction ability, and they were superior to other traditional models. The risk score and distant metastasis (M) of the five-gene signature were independent risk factors that affected DTC recurrence. A nomogram that could predict 1-year, 3-year, and 5-year DFS rate of DTC patients was established with a C-index of 0.801 (95% CI: 0.736, 0.866). Conclusion. Our study developed a prediction model based on the gene expression and clinical characteristics to predict the DFS rate of DTC patients, which may be applied to more accurately assess patient prognosis and individualized treatment.

2020 ◽  
Vol 35 (3) ◽  
pp. 41-49
Author(s):  
Lorenzo Scappaticcio ◽  
Pierpaolo Trimboli ◽  
Frederik A. Verburg ◽  
Luca Giovanella

Objective Clinical and laboratory guidelines recommend thyroglobulin antibodies (TgAbs) measurement with every thyroglobulin (Tg) measurement for the follow-up of differentiated thyroid cancer (DTC) patients. However, no evidence exists on the need for perpetual TgAbs testing in patients who are TgAb-negative at baseline. Our study was carried out to evaluate the prevalence, the dynamic changes, and the clinical significance of TgAbs that appeared de novo during the follow-up of DTC patients who were TgAb-negative at baseline. Methods The data of DTC patients with negative pre-ablation TgAbs were reviewed retrospectively. The main characteristics of patients with both transient and sustained de novo TgAbs appearance were analyzed. DTC patients with persistently negative TgAbs served as controls. Results Among 119 patients with pre-ablation negative TgAbs, 14 cases (11.7%) with de novo TgAbs appearance (10 and 4 patients with a transient and sustained de novo TgAbs appearance, respectively) were detected. No differences in disease-free survival were observed in patients with de novo TgAbs appearance compared to controls. The TgAbs peak value was higher in patients with sustained de novo appearance compared to patients with transient de novo. Two of 14 patients with de novo TgAbs developed structural disease with concurrently detectable Tg in both cases. Conclusions Transient de novo TgAbs appearance is not infrequent during DTC patients’ follow-up, and it has no apparent clinical impact. Sustained de novo TgAbs appearance is rare and may predict structural recurrences; however, similar disease-free survival was observed in patients with sustained de novo TgAbs and TgAb-negative DTC patients.


2021 ◽  
Vol 36 (2) ◽  
pp. e246-e246
Author(s):  
Fathimabeebi P. Kunjumohamed ◽  
Abdulhakeem Al Rawahi ◽  
Noor B. Al Busaidi ◽  
Hilal N. Al Musalhi

Objectives: As with global trends, the prevalence of differentiated thyroid cancer (DTC) has increased in recent years in Oman. However, to the best of our knowledge, no local studies have yet been published evaluating the prognosis of DTC cases in Oman. This study aimed to assess disease-free survival (DFS) and prognostic factors related to DTC among Omani patients attending a tertiary care center. Methods: This retrospective, observational cohort study was conducted between January 2006 and May 2016 at the National Diabetes and Endocrine Center in Oman. Data related to DFS and prognostic factors were obtained from the electronic medical records of all ≥ 18-year-old patients diagnosed with DTC during the study period. Results: A total of 346 DTC cases were identified. Overall, 82.7% of patients were disease-free at their last follow-up appointment. Univariate analysis indicated that various tumor characteristics including histological subtype (i.e., papillary carcinoma, Hurthle cell cancer, and minimally invasive follicular thyroid carcinoma), lymph node status, number of lymph node metastases, distant metastasis status, and TNM status (primary tumor (T), regional lymph node (N), distant metastasis (M) stage) were strong prognostic factors for DFS (p < 0.050). According to multivariate regression analysis, lymph node status, extrathyroidal extension, and angiovascular invasion were independent predictors of DFS (p < 0.050). Conclusions: The overall prognosis of DTC among Omani patients was excellent. Treatment and follow-up strategies for patients with DTC should be tailored based on the individual’s risk factor profile.


2012 ◽  
Vol 36 (6) ◽  
pp. 1262-1267 ◽  
Author(s):  
S. G. A. de Meer ◽  
M. Dauwan ◽  
B. de Keizer ◽  
G. D. Valk ◽  
I. H. M. Borel Rinkes ◽  
...  

Thyroid ◽  
2016 ◽  
Vol 26 (8) ◽  
pp. 1053-1060 ◽  
Author(s):  
Michael G. White ◽  
Nicole A. Cipriani ◽  
Layth Abdulrasool ◽  
Sharone Kaplan ◽  
Briseis Aschebrook-Kilfoy ◽  
...  

10.3823/2545 ◽  
2018 ◽  
Vol 11 ◽  
Author(s):  
Rita Hajj Boutros ◽  
Asma Arabi ◽  
Mahmoud Shoucair ◽  
Jaber Abbas ◽  
Ibrahim Salti

Background: Thyroid cancer is the most common endocrine malignancy. Although relatively common, to date, there is no study about its prognosis in Lebanon. The objectives of this study were to determine the disease free survival, the recurrence rate and possible predictors of recurrence, as well as the rate of post thyroidectomy complications among patients with differentiated thyroid cancer who received treatment at the American University of Beirut Medical Center. Methods and Findings: retrospective observational study of 480 cases of differentiated thyroid cancer who underwent thyroidectomy between January 1995 and June 2014. The mean age was 42±14 years. 74.4% were females. The mean tumor size was 1.9 cm±1.4. Papillary type was predominant (91%). Males had more extra-glandular extension than females (24.8% versus 10.9% respectively, p=0.001), more lymph node involvement (69.7% versus 52.9% respectively, p=0.017) and more vascular invasion (28.1% versus 14.9%, p=0.007). Around 70% of patients had at least one follow up visit after the surgery; among those, the median follow up duration was 4 years (1month-19years). At last follow-up visit, 78.7% were disease free, 14.9% had residual disease and only 6.3% had recurrent disease. By multivariate analysis, age greater than 45 years was the only independent predictor of persistence or recurrence (p=0.03) whereas both age below 45 years and lack of vascular invasion were significant predictors of disease free survival (p=0.001 and p=0.019 respectively). Conclusion: Differentiated thyroid cancer has an overall good prognosis in this cohort of Lebanese patients. Young age and lack of vascular invasion are the most important predictors of disease free survival.   Key words: Differentiated thyroid cancer: disease free survival, prognostic factors, recurrence


2015 ◽  
Vol 100 (9) ◽  
pp. 3270-3279 ◽  
Author(s):  
Aubrey A. Carhill ◽  
Danielle R. Litofsky ◽  
Douglas S. Ross ◽  
Jacqueline Jonklaas ◽  
David S. Cooper ◽  
...  

Context: Initial treatments for patients with differentiated thyroid cancer are supported primarily by single-institution, retrospective studies, with limited follow-up and low event rates. We report updated analyses of long-term outcomes after treatment in patients with differentiated thyroid cancer. Objective: The objective was to examine effects of initial therapies on outcomes. Design/Setting: This was a prospective multi-institutional registry. Patients: A total of 4941 patients, median follow-up, 6 years, participated. Intervention: Interventions included total/near-total thyroidectomy (T/NTT), postoperative radioiodine (RAI), and thyroid hormone suppression therapy (THST). Main Outcome Measure: Main outcome measures were overall survival (OS) and disease-free survival using product limit and proportional hazards analyses. Results: Improved OS was noted in NTCTCS stage III patients who received RAI (risk ratio [RR], 0.66; P = .04) and stage IV patients who received both T/NTT and RAI (RR, 0.66 and 0.70; combined P = .049). In all stages, moderate THST (TSH maintained subnormal-normal) was associated with significantly improved OS (RR stages I-IV: 0.13, 0.09, 0.13, 0.33) and disease-free survival (RR stages I-III: 0.52, 0.40, 0.18); no additional survival benefit was achieved with more aggressive THST (TSH maintained undetectable-subnormal). This remained true, even when distant metastatic disease was diagnosed during follow-up. Lower initial stage and moderate THST were independent predictors of improved OS during follow-up years 1–3. Conclusions: We confirm previous findings that T/NTT followed by RAI is associated with benefit in high-risk patients, but not in low-risk patients. In contrast with earlier reports, moderate THST is associated with better outcomes across all stages, and aggressive THST may not be warranted even in patients diagnosed with distant metastatic disease during follow-up. Moderate THST continued at least 3 years after diagnosis may be indicated in high-risk patients.


2020 ◽  
Vol 58 (5) ◽  
pp. 888-898
Author(s):  
Donglai Chen ◽  
Yiming Mao ◽  
Qifeng Ding ◽  
Wei Wang ◽  
Feng Zhu ◽  
...  

Abstract OBJECTIVES Conflicting results have been reported about the prognostic value of programmed death ligand 1 (PD-L1) protein and gene expression in lung adenocarcinoma. METHODS We performed a comprehensive online search to explore the association between PD-L1 expression (protein and messenger RNA) and overall survival (OS) or disease-free survival. Outcomes also included pooled rates of high PD-L1 protein expression in different cell types, per threshold used and per antibody used. A pooled gene expression analysis was also performed on 3 transcriptomic data sets that were obtained from The Cancer Genome Atlas database and the Gene Expression Omnibus database. RESULTS A total of 6488 patients from 25 studies were included. The pooled results suggested that high PD-L1 expression was associated with shorter OS [hazard ratio (HR) 1.57; P &lt; 0.001] and disease-free survival (HR 1.341; P = 0.037) in the overall population. The overall pooled rate of high PD-L1 protein expression was 29% (95% confidence interval 23–34%) in tumour cells. In subgroup analysis, high PD-L1 protein expression in tumour cells predicted worse OS and disease-free survival. A pooled analysis of The Cancer Genome Atlas and Gene Expression Omnibus data sets revealed that higher levels of PD-L1 messenger RNA predicted poorer OS in the entire population. CONCLUSIONS This study is, to our knowledge, the largest pooled analysis on the subject to shed light on the high expression rate of PD-L1 and the prognostic value of high PD-L1 expression in resected lung adenocarcinomas. PD-L1 gene expression is a promising prognostic factor for patients with surgically resected lung adenocarcinoma. Standardization of staining should be underscored prior to routine implementation.


2016 ◽  
Vol 39 (6) ◽  
pp. 545-558 ◽  
Author(s):  
Elisabetta Bigagli ◽  
Carlotta De Filippo ◽  
Cinzia Castagnini ◽  
Simona Toti ◽  
Francesco Acquadro ◽  
...  

2005 ◽  
Vol 23 (9) ◽  
pp. 1921-1926 ◽  
Author(s):  
Bernadette Ferraro ◽  
Gerold Bepler ◽  
Swati Sharma ◽  
Alan Cantor ◽  
Eric B. Haura

Purpose The zinc finger transcription factor early growth response gene 1 (EGR1) is underexpressed in non–small-cell lung cancer (NSCLC) compared with normal lung. EGR1 expression has been linked to tumor suppression as a result of cell cycle arrest and apoptosis through regulation of tumor suppressor pathways including PTEN. For these reasons, we hypothesized that reduced levels of EGR1 would correlate with inferior outcome in patients with NSCLC. Patients and Methods Patients who underwent surgical resection for NSCLC had RNA extracted from tumor tissue and EGR1 gene expression was quantified by real-time quantitative polymerase chain reaction. The levels of EGR1 expression were examined in relationship to patient characteristics, histology, tumor stage, PTEN expression, and overall and disease-free survival. Results EGR1 expression strongly correlated with PTEN expression (P < .0001). No correlation of EGR1 with histology or stage was detected. Patients with high levels of EGR1 had better overall and disease-free survival compared with patients with low levels of EGR1 (P = .040 and P = .096, respectively). In a stratified log-rank test, low EGR1 expression was predictive of poor survival independent of tumor stage. Conclusion EGR1 gene expression predicts PTEN levels and survival after surgical resection of NSCLC. Consistent with its known tumor suppressor properties, lower levels of EGR1 are associated with poor outcome. Identification of patients with low EGR1 therefore may identify patients at high risk for disease recurrence and may also identify patients who have tumors resistant to therapy secondary to loss of pathways such as PTEN.


2013 ◽  
Vol 1 (1) ◽  
pp. 8 ◽  
Author(s):  
Wafaey Gomaa ◽  
Mahmoud Al-Ahwal ◽  
Osman Hamour ◽  
Jaudah Al-Maghrabi

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