单位:[1]First Hosp Jilin Univ, Dept Resp Med, Changchun, Jilin, Peoples R China[2]China Japan Friendship Hosp, Dept Pulm & Crit Care Med, Beijing 100029, Peoples R China[3]Natl Ctr Resp Med, Beijing 100029, Peoples R China[4]Chinese Acad Med Sci, Inst Resp Med, Beijing 100029, Peoples R China[5]Natl Clin Res Ctr Resp Dis, Beijing 100029, Peoples R China[6]Chinese Acad Med Sci & Peking Union Med Coll, Beijing, Peoples R China[7]China Japan Friendship Hosp, Dept Radiol, Beijing, Peoples R China[8]Capital Med Univ, Beijing, Peoples R China
Background Metastatic non-small cell lung cancer (NSCLC) is mostly seen in older patients and is associated with poor prognosis. There is no reliable method to predict the prognosis of elderly patients (>= 60 years old) with metastatic NSCLC. The aim of our study was to develop and validate nomograms which accurately predict survival in this group of patients. Methods NSCLC patients diagnosed between 2010 and 2015 were all identified from the Surveillance, Epidemiology, and End Results (SEER) database. Nomograms were constructed by significant clinicopathological variables (p < 0.05) selected in multivariate Cox analysis regression. Results A total of 9584 patients met the inclusion criteria and were randomly allocated in the training (n = 6712) and validation (n = 2872) cohorts. In training cohort, independent prognostic factors included age, gender, race, grade, tumor site, pathology, T stage, N stage, radiotherapy, surgery, chemotherapy, and metastatic site (p < 0.05) for lung cancer-specific survival (LCSS) and overall survival (OS) were identified by the Cox regression. Nomograms for predicting 1-, 2-, and 3-years LCSS and OS were established and showed excellent predictive performance with a higher C-index than that of the 7th TNM staging system (LCSS: training cohort: 0.712 vs. 0.534; p < 0.001; validation cohort: 0.707 vs. 0.528; p < 0.001; OS: training cohort: 0.713 vs. 0.531; p < 0.001; validation cohort: 0.710 vs. 0.528; p < 0.001). The calibration plots showed good consistency from the predicted to actual survival probabilities both in training cohort and validation cohort. Moreover, the decision curve analysis (DCA) achieved better net clinical benefit compared with TNM staging models. Conclusions We established and validated novel nomograms for predicting LCSS and OS in elderly patients with metastatic NSCLC with desirable discrimination and calibration ability. These nomograms could provide personalized risk assessment for these patients and assist in clinical decision.
基金:
National Key R&D Program of China [2021YFC2500700]
第一作者单位:[1]First Hosp Jilin Univ, Dept Resp Med, Changchun, Jilin, Peoples R China[2]China Japan Friendship Hosp, Dept Pulm & Crit Care Med, Beijing 100029, Peoples R China[3]Natl Ctr Resp Med, Beijing 100029, Peoples R China[4]Chinese Acad Med Sci, Inst Resp Med, Beijing 100029, Peoples R China[5]Natl Clin Res Ctr Resp Dis, Beijing 100029, Peoples R China[6]Chinese Acad Med Sci & Peking Union Med Coll, Beijing, Peoples R China
通讯作者:
通讯机构:[1]First Hosp Jilin Univ, Dept Resp Med, Changchun, Jilin, Peoples R China[2]China Japan Friendship Hosp, Dept Pulm & Crit Care Med, Beijing 100029, Peoples R China[3]Natl Ctr Resp Med, Beijing 100029, Peoples R China[4]Chinese Acad Med Sci, Inst Resp Med, Beijing 100029, Peoples R China[5]Natl Clin Res Ctr Resp Dis, Beijing 100029, Peoples R China[6]Chinese Acad Med Sci & Peking Union Med Coll, Beijing, Peoples R China[*1]Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital National Center for Respiratory Medicine Institute of Respiratory Medicine, Chinese Academy of Medical Sciences National Clinical Research Center for Respiratory Diseases, Beijing 100029, China.[*2]Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
推荐引用方式(GB/T 7714):
Sun Haishuang,Liu Min,Yang Xiaoyan,et al.Construction and validation of prognostic nomograms for elderly patients with metastatic non-small cell lung cancer[J].CLINICAL RESPIRATORY JOURNAL.2022,16(5):380-393.doi:10.1111/crj.13491.
APA:
Sun, Haishuang,Liu, Min,Yang, Xiaoyan,Ren, Yanhong,Dai, Huaping&Wang, Chen.(2022).Construction and validation of prognostic nomograms for elderly patients with metastatic non-small cell lung cancer.CLINICAL RESPIRATORY JOURNAL,16,(5)
MLA:
Sun, Haishuang,et al."Construction and validation of prognostic nomograms for elderly patients with metastatic non-small cell lung cancer".CLINICAL RESPIRATORY JOURNAL 16..5(2022):380-393