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. 2024 Jan;13(1):e6751.
doi: 10.1002/cam4.6751. Epub 2023 Dec 26.

The nomogram for the prediction of overall survival after surgery in patients in early-stage NSCLC based on SEER database and external validation cohort

Hao Zhang  1   2 , Jingtong Zeng  1   2 , Xianjie Li  1   2 , Bo Zhang  1   2 , Hanqing Wang  1   2 , Quanying Tang  1   2 , Yifan Zhang  1   2 , Shihao Bao  1   2 , Lingling Zu  1   2 , Xiaohong Xu  3 , Song Xu  1   2 , Zuoqing Song  1   2
Affiliations

The nomogram for the prediction of overall survival after surgery in patients in early-stage NSCLC based on SEER database and external validation cohort

Hao Zhang et al. Cancer Med. 2024 Jan.

Abstract

Background & aims: Currently, there is a lack of effective tools for predicting the prognostic outcome of early-stage lung cancer after surgery. We aim to create a nomogram model to help clinicians assess the risk of postoperative recurrence or metastasis.

Materials and methods: This work obtained 16,459 NSCLC patients based on SEER database from 2010 to 2015. In addition, we also enrolled 385 NSCLC patients (2017/01-2019/06) into external validation cohort at Tianjin Medical University General Hospital. Univariable as well as multivariable Cox regression was carried out for identifying factors independently predicting OS. In addition, we built a nomogram by incorporating the above prognostic factors for the prediction of OS.

Results: Tumor size was positively correlated with the risk of poor differentiation. Advanced age, male and adenocarcinoma patients were factors independently predicting poor prognosis. The risk of white race is higher, followed by Black race, Asians and Indians, which is consistent with previous study. Chemotherapy is negatively related to prognostic outcome in patients of Stage IA NSCLC and positively related to that in those of Stage IB NSCLC. Lymph node dissection can reduce the postoperative mortality of patients. AUCs of the nomograms for 1, 2, and 3-year OS was 0.705, 0.712, and 0.714 for training cohort, while those were 0.684, 0.688, and 0.688 for validation cohort.

Conclusions: The nomogram could be used as a tool to predict the postoperative prognosis of patients with Stage I non-small cell lung cancer.

Keywords: nomogram; non-small cell lung cancer; prognostic factor; the Surveillance, Epidemiology, and End Results Program (SEER).

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationship.

Figures

FIGURE 1
FIGURE 1
Flow chart for screening NSCLC patients in SEER.
FIGURE 2
FIGURE 2
Independent predictors screening. Univariable (A) and multivariable (B) Cox regression of clinicopathological characteristics associated with OS in the SEER Database.
FIGURE 3
FIGURE 3
THE Kaplan–Meier survival estimates by chemotherapy, in IA.
FIGURE 4
FIGURE 4
The Kaplan–Meier survival estimates by chemotherapy, in IB.
FIGURE 5
FIGURE 5
Nomogram construction and validation. (A) A nomogram plot was constructed on the basis of chemotherapy, number of resected lymph node stations, resection type, radiation, marital status, number of resected lymph nodes, histologic type, race, tumor size, grade, gender and age. According to calibration curves, the nomogram‐predicted 1‐ (B), 2‐ (C), and 3‐year (D) OS was well consistent with real OS.
FIGURE 6
FIGURE 6
ROC curves of 1‐, 2‐, and 3‐year OS for patients and DCA curves based on nomogram. (A, D) training, (B, E) test, and (C, F) external validation cohorts.
FIGURE 7
FIGURE 7
Kaplan–Meier survival curve show overall survival of early‐stage NSCLC patients in different groups. (A‐C) Training cohort (A); test cohort (B); and external validation cohort (C).
See this image and copyright information in PMC

References

    1. Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17‐48. doi:10.3322/caac.21763 - DOI - PubMed
    1. Chen Z, Fillmore CM, Hammerman PS, Kim CF, Wong KK. Non‐small‐cell lung cancers: a heterogeneous set of diseases. Nat Rev Cancer. 2014;14(8):535‐546. doi:10.1038/nrc3775 - DOI - PMC - PubMed
    1. Ettinger DS, Wood DE, Aisner DL, et al. NCCN guidelines insights: non‐small cell lung cancer, version 2.2021. J Natl Compr Canc Netw. 2021;19(3):254‐266. doi:10.6004/jnccn.2021.0013 - DOI - PubMed
    1. Hung JJ, Hsu WH, Hsieh CC, et al. Post‐recurrence survival in completely resected stage I non‐small cell lung cancer with local recurrence. Thorax. 2009;64(3):192‐196. doi:10.1136/thx.2007.094912 - DOI - PubMed
    1. Hung JJ, Jeng WJ, Hsu WH, et al. Prognostic factors of postrecurrence survival in completely resected stage I non‐small cell lung cancer with distant metastasis. Thorax. 2010;65(3):241‐245. doi:10.1136/thx.2008.110825 - DOI - PubMed

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