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

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningfagfællebedømt

  • Yuan Zeng
  • Nicholas Mayne
  • Chi Fu Jeffrey Yang
  • Thomas A. D’Amico
  • Calvin S.H. Ng
  • Chia chuan Liu
  • Petersen, René Horsleben
  • 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

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 low-risk 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 < 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 - 2019

ID: 226258755