Department of Thoracic Medical Oncology, Peking University Cancer Hospital & Institute, Beijing, China
Bo Jia , Ziping Wang , Qiwen Zheng , Yuyan Wang , Xinmeng Qi
Background: This study aimed to predict the probability of death for non-small cell lung cancer (NSCLC) patients who received surgery and construct a comprehensive nomogram prognostic model to predict cumulative incidence of death resulting from NSCLC, other cancers, and non–cancer-related causes. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute across 18 cancer registry sites in the United States were used for the present study. We estimated probabilities of death resulting from NSCLC, other cancers, and non-cancer causes for NSCLC patients who received surgery and analyzed relationships of patients' characteristics with probability of death. A nomogram prognostic model was used to predict the probability of death. Results: The entire cohort comprised 44,880 NSCLC patients who received surgery from 2004 to 2014. Male, race, tumor anatomic sites, histologic subtype, tumor differentiation, tumor size, tumor extent, lymph node involvement, examined lymph node, positive lymph node, type of surgery showed significant associations with probability of death (P < 0.001). Chemotherapy was associated with a significantly lower cumulative incidence of death (P < 0.001) while radiotherapy was associated with a significantly higher incidence of death (P < 0.001). The nomogram was constructed based on multivariate models with training data set. The probability of 5- or 10-year death can be calculated using this nomogram. In the validation cohort, the unadjusted C-index was 0.73 (95% CI, 0.72-0.74), 0.71 (95% CI, 0.66-0.75) and 0.69 (95% CI, 0.68-0.70) for lung cancer death, other cancer death and non-cancer death causes. Conclusions: A prognostic nomogram model was developed for predicting the probability of death for NSCLC patients who received surgery. This nomogram may be useful for clinicians to develop the best treatment strategies for NSCLC patients after surgery.
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Funded by Conquer Cancer
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