Department of Thoracic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China.
Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
BMC Cancer. 2023 Jul 31;23(1):715. doi: 10.1186/s12885-023-11158-w.
Radical resection plus lymph node dissection is a common treatment for patients with TNM non-small cell lung cancer (NSCLC). Few models predicted the survival outcomes of these patients. This study aimed to developed a nomogram for predicting their overall survival (OS).
This study involved 3002 patients with TNM NSCLC after curative resection between January 1999 and October 2013. 1525 Patients from Sun Yat-sen University Cancer Center were randomly allocated to training cohort and internal validation cohort in a ratio of 7:3. 1477 patients from ten institutions were recruited as external validation cohort. A nomogram was constructed based on the training cohort and validated by internal and external validation cohort to predict the OS of these patients. The accuracy and practicability were tested by Harrell's C-indexes, calibration plots and decision curve analyses (DCA).
Age, sex, histological classification, pathological T stage, and HI standard were independent factors for OS and were included in our nomogram. The C-index of the nomogram for OS estimates were 0.671 (95% CI, 0.637-0.705),0.632 (95% CI, 0.581-0.683), and 0.645 (95% CI, 0.617-0.673) in the training cohorts, internal validation cohorts, and external validation cohort, respectively. The calibration plots and DCA for predictions of OS were in excellent agreement. An online version of the nomogram was built for convenient clinical practice.
Our nomogram can predict the OS of patients with TNM NSCLC after curative resection. The online version of our nomogram offer opportunities for fast personalized risk stratification and prognosis prediction in clinical practice.
根治性切除术加淋巴结清扫术是治疗 TNM 非小细胞肺癌（NSCLC）患者的常用方法。很少有模型可以预测这些患者的生存结局。本研究旨在建立一个预测总生存期（OS）的列线图。
本研究纳入了 1999 年 1 月至 2013 年 10 月期间接受根治性切除术的 3002 例 TNM NSCLC 患者。中山大学肿瘤中心的 1525 例患者按 7:3 的比例随机分配至训练队列和内部验证队列。另外，从 10 个机构招募了 1477 例患者作为外部验证队列。基于训练队列构建了列线图，并通过内部和外部验证队列进行验证，以预测这些患者的 OS。通过 Harrell's C 指数、校准图和决策曲线分析（DCA）来测试准确性和实用性。
年龄、性别、组织学分类、病理 T 分期和 HI 标准是 OS 的独立因素，被纳入我们的列线图。OS 估计的列线图 C 指数在训练队列、内部验证队列和外部验证队列中分别为 0.671（95%CI，0.637-0.705）、0.632（95%CI，0.581-0.683）和 0.645（95%CI，0.617-0.673）。校准图和 DCA 均显示对 OS 的预测有很好的一致性。我们还建立了列线图的在线版本，以便于临床实践。
我们的列线图可以预测接受根治性切除术的 TNM NSCLC 患者的 OS。我们的列线图的在线版本为临床实践中快速的个性化风险分层和预后预测提供了机会。
