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A nomogram to predict the survival of stage IIIA-N2 non-small cell lung cancer after surgery.
- Source :
-
The Journal of thoracic and cardiovascular surgery [J Thorac Cardiovasc Surg] 2018 Apr; Vol. 155 (4), pp. 1784-1792.e3. Date of Electronic Publication: 2017 Dec 20. - Publication Year :
- 2018
-
Abstract
- Objective: Postoperative survival of patients with stage IIIA-N2 non-small cell lung cancer (NSCLC) is highly heterogeneous. Here, we aimed to identify variables associated with postoperative survival and develop a tool for survival prediction.<br />Methods: A retrospective review was performed in the Surveillance, Epidemiology, and End Results database from January 2004 to December 2009. Significant variables were selected by use of the backward stepwise method. The nomogram was constructed with multivariable Cox regression. The model's performance was evaluated by concordance index and calibration curve. The model was validated via an independent cohort from the Jiangsu Cancer Hospital Lung Cancer Center.<br />Results: A total of 1809 patients with stage IIIA-N2 NSCLC who underwent surgery were included in the training cohort. Age, sex, grade, histology, tumor size, visceral pleural invasion, positive lymph nodes, lymph nodes examined, and surgery type (lobectomy vs pneumonectomy) were identified as significant prognostic variables using backward stepwise method. A nomogram was developed from the training cohort and validated using an independent Chinese cohort. The concordance index of the model was 0.673 (95% confidence interval, 0.654-0.692) in training cohort and 0.664 in validation cohort (95% confidence interval, 0.614-0.714). The calibration plot showed optimal consistency between nomogram predicted survival and observed survival. Survival analyses demonstrated significant differences between different subgroups stratified by prognostic scores.<br />Conclusions: This nomogram provided the individual survival prediction for patients with stage IIIA-N2 NSCLC after surgery, which might benefit survival counseling for patients and clinicians, clinical trial design and follow-up, as well as postoperative strategy-making.<br /> (Copyright © 2017 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Non-Small-Cell Lung mortality
Carcinoma, Non-Small-Cell Lung pathology
China epidemiology
Clinical Decision-Making
Female
Humans
Lung Neoplasms mortality
Lung Neoplasms pathology
Male
Middle Aged
Neoplasm Staging
Predictive Value of Tests
Reproducibility of Results
Retrospective Studies
Risk Assessment
Risk Factors
SEER Program
Time Factors
Treatment Outcome
United States epidemiology
Young Adult
Carcinoma, Non-Small-Cell Lung surgery
Decision Support Techniques
Lung Neoplasms surgery
Nomograms
Pneumonectomy adverse effects
Pneumonectomy mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1097-685X
- Volume :
- 155
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of thoracic and cardiovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 29554790
- Full Text :
- https://doi.org/10.1016/j.jtcvs.2017.11.098