Construction and validation of a nomogram for predicting lateral lymph node metastasis in Pediatric and Adolescent with differentiated thyroid carcinoma

Background: In the pediatric and adolescent populations, the occurrence of lateral lymph node metastasis (LNM) in cases of differentiated thyroid carcinoma (DTC) is a significant risk factor associated with unfavorable prognosis. However, limited research has been conducted to specifically investigate the identification of risk factors and the development of prediction models for lateral LNM in DTC among the pediatric and adolescent populations. Methods In this study, we conducted a retrospective analysis of the clinical characteristics of pediatric and adolescent patients diagnosed with DTC. The data was obtained from the Surveillance, Epidemiology, and End Results (SEER) database for the period between 2000 and 2020. Additionally, we included patients treated at the Departments of Breast and Thyroid Surgery in the Second Clinical Medical College, Affiliated Fifth People's Hospital of Chengdu University of Traditional Chinese Medicine and The General Hospital of Western Theater Command from 2010 to 2020. Results A cohort of 2,631 patients from the SEER database, along with an additional 339 patients from our departments who met the specified inclusion criteria, were included in this study. Subsequently, four clinical variables, namely age, tumor size, multifocality, and extrathyroidal invasion, were identified as being significantly associated with lateral LNM in pediatric and adolescent patients with DTC. These variables were then utilized to construct a nomogram, which demonstrated effective discrimination with a concordance index (C-index) of 0.731. Furthermore, the performance of this model was validated through both internal and external assessments. yielding C-index values of 0.721 and 0.712, respectively. Afterward, a decision curve analysis was conducted to assess the viability of this nomogram in predicting lymph node metastasis. Conclusion The present study successfully developed a nomogram model based on visualized multipopulationsal data. Our findings indicate that several clinical characteristics are significantly correlated with lateral LNM in pediatric and adolescent DTC patients. These results have important implications for clinicians, as they can utilize this model to make personalized clinical decisions for pediatric and adolescents populations.