Zeng Yuan, Mayne Nicholas, Yang Chi-Fu Jeffrey, Liu Jun, Cui Fei, Li Jingpei, Liang Wenhua, He Jianxing
Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Guangzhou Institute of Respiratory Disease & China State Key Laboratory of Respiratory Disease & National Clinical Research Center for Respiratory Disease, Guangzhou, China.
Transl Lung Cancer Res. 2021 Apr;10(4):1690-1699. doi: 10.21037/tlcr-20-1220.
Chemotherapy is a common treatment for patients with resected non-small cell lung cancer (NSCLC). However, there are few models for predicting the survival outcomes of these patients. Here, we developed a clinical nomogram for predicting overall survival (OS) in this cohort.
A total of 16,661 patients with resected NSCLC treated with chemotherapy were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. We identified prognostic factors and integrated them into a nomogram. The model was subjected to bootstrap internal validation using the SEER database and external validation using a database in China and the National Cancer Database (NCDB). The model's predictive accuracy and discriminative ability were tested by calibration and concordance index (C-index).
Age, sex, number of dissected lymph nodes, extent of surgery, N stage, T stage, and grade were independent factors for OS and were integrated into the model. The calibration curves for probability of 1-, 3-, and 5-year OS showed excellent agreement between the predicted and actual survivals. The C-index of the nomogram was higher than that of the Tumor-Node-Metastasis staging system for predicting OS (training cohort, 0.62 0.58; China cohort, 0.68 0.63; NCDB cohort, 0.59 0.57).
We developed a nomogram that can present individual prediction of OS for patients with resected NSCLC who are undergoing chemotherapy. This practical prognostic tool may help clinicians in treatment planning.
化疗是切除的非小细胞肺癌(NSCLC)患者的常见治疗方法。然而,预测这些患者生存结果的模型很少。在此,我们开发了一种临床列线图来预测该队列患者的总生存期(OS)。
从监测、流行病学和最终结果(SEER)数据库中提取了总共16661例接受化疗的切除NSCLC患者。我们确定了预后因素并将其整合到列线图中。该模型使用SEER数据库进行自举内部验证,并使用中国的一个数据库和国家癌症数据库(NCDB)进行外部验证。通过校准和一致性指数(C指数)测试模型的预测准确性和判别能力。
年龄、性别、清扫淋巴结数量、手术范围、N分期、T分期和分级是OS的独立因素,并被整合到模型中。1年、3年和5年OS概率的校准曲线显示预测生存与实际生存之间具有良好的一致性。列线图的C指数高于肿瘤-淋巴结-转移分期系统预测OS的C指数(训练队列,0.62对0.58;中国队列,0.68对0.63;NCDB队列,0.59对0.57)。
我们开发了一种列线图,可为接受化疗且已切除NSCLC的患者提供OS的个体预测。这种实用的预后工具可能有助于临床医生进行治疗规划。