Back to Search
Start Over
A Nomogram for Predicting Cancer-Specific Survival of TNM 8th Edition Stage I Non-small-cell Lung Cancer.
- Source :
-
Annals of surgical oncology [Ann Surg Oncol] 2019 Jul; Vol. 26 (7), pp. 2053-2062. Date of Electronic Publication: 2019 Mar 21. - Publication Year :
- 2019
-
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.<br />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).<br />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).<br />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.
- Subjects :
- Adenocarcinoma pathology
Adenocarcinoma therapy
Adenocarcinoma, Bronchiolo-Alveolar pathology
Adenocarcinoma, Bronchiolo-Alveolar therapy
Aged
Carcinoma, Non-Small-Cell Lung pathology
Carcinoma, Non-Small-Cell Lung therapy
Carcinoma, Squamous Cell pathology
Carcinoma, Squamous Cell therapy
Cohort Studies
Combined Modality Therapy
Female
Follow-Up Studies
Humans
Lung Neoplasms pathology
Lung Neoplasms therapy
Male
Middle Aged
Risk Factors
SEER Program
Survival Rate
Adenocarcinoma mortality
Adenocarcinoma, Bronchiolo-Alveolar mortality
Carcinoma, Non-Small-Cell Lung mortality
Carcinoma, Squamous Cell mortality
Lung Neoplasms mortality
Neoplasm Staging standards
Nomograms
Subjects
Details
- Language :
- English
- ISSN :
- 1534-4681
- Volume :
- 26
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Annals of surgical oncology
- Publication Type :
- Academic Journal
- Accession number :
- 30900105
- Full Text :
- https://doi.org/10.1245/s10434-019-07318-7