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. 2023 Mar;17(3):197-210.
doi: 10.1111/crj.13586. Epub 2023 Jan 31.

Clinicopathological features and prognostic nomogram of giant cell carcinoma of the lung: A population-based study

Jiang He  1 , Jin-Ping Ni  2 , Guang-Bin Li  1 , Jie Yao  1 , Bin Ni  1
Affiliations

Clinicopathological features and prognostic nomogram of giant cell carcinoma of the lung: A population-based study

Jiang He et al. Clin Respir J. 2023 Mar.

Abstract

Background: Due to its rarity, the features and prognosis of giant cell carcinoma of the lung (GCCL) are not well defined. The present study aimed to describe the clinicopathological features and prognostic analysis of this rare disease, compare it with lung adenocarcinoma (LAC), further determine the prognostic factors and establish a nomogram.

Methods: Patients diagnosed with GCCL and LAC were identified from the SEER database between 2004 and 2016. The features and survival between GCCL and LAC were compared in the unmatched and matched cohorts after propensity score matching (PSM) analysis. Univariate and multivariate Cox analyses were used to identify the prognostic factors, and a nomogram was constructed. Area under the curve (AUC), C-index, calibration curve and decision curve analysis (DCA) were used to confirm the established nomogram.

Results: A total of 295 patient diagnosed with GCCL and 149 082 patients with LAC were identified. Compared with LAC, patients with GCCL tend to be younger, male, black and have pathological Grade III/IV GCCL, more proportion of AJCC-TNM-IV, T3/T4 and distant metastases. The 1-, 2- and 5-year OS rates of the patients with GCCL were 21.7%, 13.4% and 7.9%, respectively. The median OS and CSS were 3 and 4 months, respectively. Patients with GCCL had significantly shorter OS and CSS than those with LAC in the unmatched and matched cohorts after PSM. Multivariate Cox analysis demonstrated that T, N and M stages and use of chemotherapy and surgery were independent of survival. Furthermore, we constructed a prognostic nomogram for OS and CSS by using independent prognostic factors. The C-index of OS-specific nomogram is 0.78 (0.74-0.81), and the C-index of CSS-specific nomogram is 0.77 (0.73-0.80). The calibration curve and ROC analysis showed good predictive capability of these nomograms. DCA showed that the nomogram had greater clinical practical value in predicting the OS and CSS of GCCL than TNM staging.

Conclusion: GCCL have distinct clinicopathological characteristics and significantly worse clinical outcomes. Prognostic nomograms for overall survival (OS) and CSS were constructed.

Keywords: SEER database; giant cell carcinoma of the lung; nomogram; propensity score matching analysis.

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Conflict of interest statement

All authors declare no conflict of interests.

Figures

FIGURE 1
FIGURE 1
Kaplan–Meier analysis comparing overall survival and cancer‐specific survival between patients with GCCL and LAC in the entire cohort (A,B) and in the matched cohort (E,F). Overall survival and cancer‐specific survival among GCCL patients with different AJCC‐TNM staging (C,D)
FIGURE 2
FIGURE 2
Nomogram for predicting the OS (A) and CSS (B) of patients with GCCL
FIGURE 3
FIGURE 3
Calibration curves of the OS‐/CSS‐specific nomograms. Calibration curves of 1‐, 2‐ and 5‐year OS (A) and CSS (B) for patients with GCCL
FIGURE 4
FIGURE 4
ROC curves analysis and DCA of the OS‐/CSS‐specific nomogram. ROC curves of the ability of nomogram to predict 1‐, 2‐ and 5‐year OS and CSS (A). DCA of the nomogram and TNM stage for OS and CSS prediction of patients with GCCL (B)
See this image and copyright information in PMC

References

    1. Steuer CE, Behera M, Liu Y, et al. Pulmonary sarcomatoid carcinoma: an analysis of the National Cancer Data Base. Clin Lung Cancer. 2017;18(3):286‐292. doi:10.1016/j.cllc.2016.11.016 - DOI - PubMed
    1. Fujii Y, Homma S, Yoshida T, Taketomi A. Jejunal intussusception caused by metastasis of a giant cell carcinoma of the lung. BMJ Case Rep. 2016;2016:bcr2016216030. doi:10.1136/bcr-2016-216030 - DOI - PMC - PubMed
    1. Weng SS, Cao Y, Tang XJ, et al. Epidemiological features of lung giant cell carcinoma and therapy for patients with EGFR mutations based on case reports and the surveillance, epidemiology, and end results (SEER) database. Oncotarget. 2017;8(15):25323‐25333. doi:10.18632/oncotarget.15831 - DOI - PMC - PubMed
    1. Li X, Zhang Z, Liu J, Wang D, Wei S, Chen J. Molecular features of giant‐cell carcinoma of the lung: a case report and literature review. Onco Targets Ther. 2018;11:751‐756. doi:10.2147/OTT.S150124 - DOI - PMC - PubMed
    1. Weissferdt A, Moran CA. Primary giant cell carcinomas of the lung: a clinicopathological and immunohistochemical analysis of seven cases. Histopathology. 2016;68(5):680‐685. doi:10.1111/his.12798 - DOI - PubMed