Nomogram model for predicting cause-specific mortality in patients with stage I small-cell lung cancer: a competing risk
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RESEARCH ARTICLE
Open Access
Nomogram model for predicting causespecific mortality in patients with stage I small-cell lung cancer: a competing risk analysis Jianjie Li1†, Qiwen Zheng2†, Xinghui Zhao1†, Jun Zhao1, Tongtong An1, Meina Wu1, Yuyan Wang1, Minglei Zhuo1, Jia Zhong1, Xue Yang1, Bo Jia1, Hanxiao Chen1, Zhi Dong1, Jingjing Wang1, Yujia Chi1, Xiaoyu Zhai1 and Ziping Wang1*
Abstract Background: The five-year cumulative incidence rate in patients diagnosed with stage I small-cell lung cancer (SCLC) who were instructed to undergo surgery was from 40 to 60%.The death competition influence the accuracy of the classical survival analyses. The aim of the study is to investigate the mortality of stage I small-cell lung cancer (SCLC) patients in the presence of competing risks according to a proportional hazards model, and to establish a competing risk nomogram to predict probabilities of both cause-specific death and death resulting from other causes. Methods: The study subjects were patients diagnosed with stage I SCLC according to ICD-O-3. First, the cumulative incidence functions (CIFs) of cause-specific death, as well as of death resulting from other causes, were calculated. Then, a proportional hazards model for the sub-distribution of competing risks and a monogram were constructed to evaluate the probability of mortality in stage I SCLC patients. Results: 1811 patients were included in this study. The five-year probabilities of death due to specific causes and other causes were 61.5 and 13.6%, respectively. Tumor size, extent of tumor, surgery, and radiotherapy were identified as the predictors of death resulting from specific causes in stage I SCLC. The results showed that surgery could effectively reduce the cancer-specific death, and the one-year cumulative incidence dropped from 34.5 to 11.2%. Like surgery, chemotherapy and radiotherapy improved the one-year survival rate. (Continued on next page)
* Correspondence: [email protected] † Jianjie Li, Qiwen Zheng and Xinghui Zhao contributed equally to this work and should be considered co-first authors. 1 Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Thoracic Medical Oncology, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing 100142, China Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not pe
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