A Nomogram for Predicting Cancer-Specific Survival of TNM 8th Edition Stage I Non-small-cell Lung Cancer

Yuan Zeng, Nicholas Mayne, Chi Fu Jeffrey Yang, Thomas A. D’Amico, Calvin S.H. Ng, Chia chuan Liu, René Horsleben Petersen, Gaetano Rocco, Alessandro Brunelli, Jun Liu, Yang Liu, Weizhe Huang, Jiaxi He, Wei Wang, Long Jiang, Fei Cui, Wenjun Wang, Wenhua Liang*, Jianxing He*, the AME Thoracic Surgery Collaborative Group

*Corresponding author af dette arbejde
18 Citationer (Scopus)

Abstract

Background. Models for predicting the survival outcomes of stage I non-small-cell lung cancer (NSCLC) defined by the newly released 8th edition TNM staging system are scarce. This study aimed to develop a nomogram for predicting the cancer-specific survival (CSS) of these patients and identifying individuals with a higher risk for CSS. Methods. A total of 30,475 NSCLC cases were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We identified and integrated the risk factors to build a nomogram. The model was subjected to bootstrap internal validation with the SEER database, and external validation with a multicenter cohort of 1133 patients from China. The difference in the impact of adjuvant chemotherapy on model-defined high-and lowrisk patients was examined using the National Cancer Database (NCDB). Results. Eight independent prognostic factors were identified and integrated into the model. The calibration curves showed good agreement. The concordance index (C-index) of the nomogram was higher than that of the staging system (IA1, IA2, IA3, and IB) (internal validation set 0.63 vs. 0.56; external validation set 0.66 vs. 0.55; both p *lt; 0.01). Specifically, 21.7% of stage IB patients (7.5% of all stage I) were categorized into the high-risk group (score[30). There was a significant interaction effect between the adjuvant chemotherapy and risk groups in the NCDB cohort (p = 0.003). Conclusions. We established a practical nomogram to predict CSS for 8th edition stage I NSCLC. A prospective study is warranted to determine its role in identifying adjuvant chemotherapy candidates.

OriginalsprogEngelsk
TidsskriftAnnals of Surgical Oncology
Vol/bind26
Udgave nummer7
Sider (fra-til)2053-2062
ISSN1068-9265
DOI
StatusUdgivet - jul. 2019

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