{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T01:36:35Z","timestamp":1792892195756,"version":"4.5.0"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:00:00Z","timestamp":1750118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 82270830"],"award-info":[{"award-number":["No. 82270830"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Current guidelines provide a recognized yet broad framework for stratifying recurrence risk in differentiated thyroid cancer (DTC) patients. More precise tools are needed for intermediate- and high-risk groups. This study aims to identify recurrence-associated risk factors and develop a machine learning-based predictive model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective analysis, 2,388 DTC patients were randomly assigned to a training group (1,910 cases) and a validation group (478 cases). Predictive factors were identified using univariate and multivariate analyses. Six machine learning models were trained and validated, with performance evaluated through accuracy, area under the curve, and clinical utility via decision curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Independent risk factors for recurrence included intraglandular dissemination, total tumor size, bilateral cervical lymph node involvement, and Hashimoto\u2019s thyroiditis, while normal\/elevated TSH and multifocal nodules were protective. The random forest model demonstrated the best performance (training accuracy: 0.801; validation accuracy: 0.808). A random forest-based online calculator was developed to facilitate individualized risk assessment in clinical settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The random forest model effectively predicts DTC recurrence, offering a practical tool for individualized risk assessment and aiding clinical decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fendo.2025.1552479","type":"journal-article","created":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:10:37Z","timestamp":1750119037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["A machine learning-based model for predicting recurrence in intermediate- and high-risk differentiated thyroid cancer: insights from a retrospective single-center study of 2388 patients"],"prefix":"10.3389","volume":"16","author":[{"given":"Yi","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zimei","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwen","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianing","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiran","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Ming","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(94)90321-2","article-title":"Long-term impact of initial surgical and medical therapy on papillary and follicular thyroid cancer","volume":"97","author":"Mazzaferri","year":"1994","journal-title":"Am J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-020-00448-z","article-title":"Current practice in patients with differentiated thyroid cancer","volume":"17","author":"Schlumberger","year":"2021","journal-title":"Nat Rev Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/thy.2015.0020","article-title":"2015 American thyroid association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the american thyroid association guidelines task force on thyroid nodules and differentiated thyroid cancer","volume":"26","author":"Haugen","year":"2016","journal-title":"Thyroid Off J Am Thyroid Assoc"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2024.0128","article-title":"Reoperation rates after initial thyroid lobectomy for patients with thyroid cancer: A national cohort study","volume":"34","author":"Kheng","year":"2024","journal-title":"Thyroid Off J Am Thyroid Assoc"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(19)30149-4","article-title":"Big data and machine learning algorithms for health-care delivery","volume":"20","author":"Ngiam","year":"2019","journal-title":"Lancet Oncol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2023.01.035","article-title":"From patterns to patients: Advances in clinical machine learning for cancer diagnosis, prognosis, and treatment","volume":"186","author":"Swanson","year":"2023","journal-title":"Cell"},{"key":"B7","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1186\/s13073-021-00968-x","article-title":"Deep learning in cancer diagnosis, prognosis and treatment selection","volume":"13","author":"Tran","year":"2021","journal-title":"Genome Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1186\/s12957-017-1099-2","article-title":"Diagnostic accuracy of ultrasonographic features for lymph node metastasis in papillary thyroid microcarcinoma: a single-center retrospective study","volume":"15","author":"Liu","year":"2017","journal-title":"World J Surg Oncol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"38","DOI":"10.2214\/AJR.09.3128","article-title":"Diagnostic approach for evaluation of lymph node metastasis from thyroid cancer using ultrasound and fine-needle aspiration biopsy","volume":"194","author":"Sohn","year":"2010","journal-title":"AJR Am J Roentgenol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2009.03537.x","article-title":"Coexistence of chronic lymphocytic thyroiditis is associated with lower recurrence rates in patients with papillary thyroid carcinoma","volume":"71","author":"Kim","year":"2009","journal-title":"Clin Endocrinol (Oxf)"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2021.772071","article-title":"The impact of coexistent hashimoto\u2019s thyroiditis on central compartment lymph node metastasis in papillary thyroid carcinoma","volume":"12","author":"Liu","year":"2021","journal-title":"Front Endocrinol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1002\/mpr.329","article-title":"Multiple imputation by chained equations: what is it and how does it work","volume":"20","author":"Azur","year":"2011","journal-title":"Int J Methods Psychiatr Res"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4067","article-title":"Multiple imputation using chained equations: Issues and guidance for practice","volume":"30","author":"White","year":"2011","journal-title":"Stat Med"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1177\/09622802231198795","article-title":"Logistic regression vs. predictive mean matching for imputing binary covariates","volume":"32","author":"Austin","year":"2023","journal-title":"Stat Methods Med Res"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1109\/TPAMI.2019.2895794","article-title":"Calibrating classification probabilities with shape-restricted polynomial regression","volume":"41","author":"Wang","year":"2019","journal-title":"IEEE Trans Pattern Anal Mach Intell"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X06295361","article-title":"Decision curve analysis: a novel method for evaluating prediction models","volume":"26","author":"Vickers","year":"2006","journal-title":"Med Decis Mak Int J Soc Med Decis Mak"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1007\/s12022-015-9382-7","article-title":"Histopathological evidence of lymph node metastasis in papillary thyroid carcinoma","volume":"26","author":"Can","year":"2015","journal-title":"Endocr Pathol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1428274","article-title":"Intraglandular dissemination: a special pathological feature","volume":"14","author":"Zhang","year":"2024","journal-title":"Front Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.2719","article-title":"Trends in thyroid cancer incidence and mortality in the United States, 1974-2013","volume":"317","author":"Lim","year":"2017","journal-title":"JAMA"},{"key":"B20","doi-asserted-by":"publisher","first-page":"14","DOI":"10.14740\/wjon1728","article-title":"Autoimmune thyroid disease and differentiated thyroid carcinoma: A review of the mechanisms that explain an intriguing and exciting relationship","volume":"15","author":"Vargas-Uricoechea","year":"2024","journal-title":"World J Oncol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3275\/8579","article-title":"Both thyroid autoimmunity and increased serum TSH are independent risk factors for Malignancy in patients with thyroid nodules","volume":"36","author":"Boi","year":"2013","journal-title":"J Endocrinol Invest"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000570","article-title":"Hashimoto\u2019s thyroiditis as a risk factor for thyroid cancer","volume":"27","author":"Feldt-Rasmussen","year":"2020","journal-title":"Curr Opin Endocrinol Diabetes Obes"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1016\/j.semcancer.2019.05.019","article-title":"Thyroid autoimmune disorders and cancer","volume":"64","author":"Ferrari","year":"2020","journal-title":"Semin Cancer Biol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.mce.2009.10.003","article-title":"Thyroid cancer and inflammation","volume":"321","author":"Guarino","year":"2010","journal-title":"Mol Cell Endocrinol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.932353","article-title":"RET signaling pathway and RET inhibitors in human cancer","volume":"12","author":"Regua","year":"2022","journal-title":"Front Oncol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-0240","article-title":"RET\/papillary thyroid cancer rearrangement in nonneoplastic thyrocytes: follicular cells of Hashimoto\u2019s thyroiditis share low-level recombination events with a subset of papillary carcinoma","volume":"91","author":"Rhoden","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2023.0353","article-title":"Association between eight autoimmune diseases and thyroid cancer: A nationwide cohort study","volume":"34","author":"Park","year":"2024","journal-title":"Thyroid Off J Am Thyroid Assoc"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1846","DOI":"10.1038\/s41598-017-02165-6","article-title":"Total tumour diameter is superior to unifocal diameter as a predictor of papillary thyroid microcarcinoma prognosis","volume":"7","author":"Liu","year":"2017","journal-title":"Sci Rep"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-019-01147-x","article-title":"Total tumor diameter: the neglected value in papillary thyroid microcarcinoma","volume":"43","author":"Feng","year":"2020","journal-title":"J Endocrinol Invest"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2654-2","article-title":"Multifocality and total tumor diameter predict central neck lymph node metastases in papillary thyroid microcarcinoma","volume":"20","author":"Zhao","year":"2013","journal-title":"Ann Surg Oncol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.794399","article-title":"Analysis of the relevance of the ultrasonographic features of papillary thyroid carcinoma and cervical lymph node metastasis on conventional and contrast-enhanced ultrasonography","volume":"11","author":"Xue","year":"2021","journal-title":"Front Oncol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1089\/thy.2022.0346","article-title":"History of thyroid ultrasound","volume":"33","author":"Levine","year":"2023","journal-title":"Thyroid Off J Am Thyroid Assoc"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2007.12.003","article-title":"Sonographic imaging of thyroid nodules and cervical lymph nodes","volume":"37","author":"Fish","year":"2008","journal-title":"Endocrinol Metab Clin North Am"},{"key":"B34","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/j.suc.2004.04.007","article-title":"Ultrasound in head and neck surgery: thyroid, parathyroid, and cervical lymph nodes","volume":"84","author":"Senchenkov","year":"2004","journal-title":"Surg Clin North Am"},{"key":"B35","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1016\/j.yfrne.2018.06.006","article-title":"The forgotten effects of thyrotropin-releasing hormone: Metabolic functions and medical applications","volume":"52","author":"Fr\u00f6hlich","year":"2019","journal-title":"Front Neuroendocrinol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-16-0328","article-title":"WOMEN IN CANCER THEMATIC REVIEW: Thyroid-stimulating hormone in thyroid cancer: does it matter","volume":"23","author":"Nieto","year":"2016","journal-title":"Endocr Relat Cancer"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.24503","article-title":"Combined prognostic value of preoperative serum thyrotrophin and thyroid hormone concentration in papillary thyroid cancer","volume":"36","author":"Liu","year":"2022","journal-title":"J Clin Lab Anal"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2015142470","article-title":"Association of preoperative US features and recurrence in patients with classic papillary thyroid carcinoma","volume":"277","author":"Kim","year":"2015","journal-title":"Radiology"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1089\/thy.2020.0921","article-title":"Risk factors for recurrence of follicular thyroid cancer: A systematic review","volume":"31","author":"Gr\u00f8nlund","year":"2021","journal-title":"Thyroid Off J Am Thyroid Assoc"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-07-0603","article-title":"Macroscopic lymph-node involvement and neck dissection predict lymph-node recurrence in papillary thyroid carcinoma","volume":"158","author":"Bardet","year":"2008","journal-title":"Eur J Endocrinol"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10144","article-title":"Risk factors for recurrence in patients with papillary thyroid carcinoma undergoing modified radical neck dissection","volume":"103","author":"Lee","year":"2016","journal-title":"Br J Surg"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.48550\/arXiv.2402.02401","article-title":"AI-generated content enhanced computer-aided diagnosis model for thyroid nodules: A chatGPT-style assistant","author":"Yao","year":"2024"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2023.111033","article-title":"The auxiliary diagnosis of thyroid echogenic foci based on a deep learning segmentation model: A two-center study","volume":"167","author":"Liu","year":"2023","journal-title":"Eur J Radiol"},{"key":"B44","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1038\/s41746-025-01652-9","article-title":"Multimodal GPT model for assisting thyroid nodule diagnosis and management","volume":"8","author":"Yao","year":"2025","journal-title":"NPJ Digit Med"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1552479\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,17]],"date-time":"2025-06-17T00:10:38Z","timestamp":1750119038000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1552479\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,17]]},"references-count":44,"alternative-id":["10.3389\/fendo.2025.1552479"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1552479","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,17]]},"article-number":"1552479"}}